Hepatitis C virus (HCV)
infection is the leading cause of chronic liver-related diseases, including
cirrhosis, liver failure, and
hepatocellular carcinoma. Currently, no effective
vaccine is available for HCV
infection.
Polyethylene glycol interferon-α (PegIFN-α) in combination with
ribavirin (RBV) is the standard of care (SOC) for
chronic hepatitis C. However, the efficacy of PegIFN-α and RBV combination
therapy is less than 50% for genotype 1 HCV, which is the dominant virus in humans. In addition, IFN and RBV have several severe side effects. Therefore, strategies to improve sustained virological response (SVR) rates have been an important focus for clinical physicians. The
serine protease inhibitors telaprevir and
boceprevir were approved by the United States Food and Drug Administration in 2011. The addition of HCV
protease inhibitors to the SOC has significantly improved the efficacy of treatments for HCV
infection. Several direct-acting
antiviral drugs currently in late-stage clinical trials, both with and without peg-IFN and RBV, have several advantages over the previous SOC, including higher specificity and efficacy, fewer side effects, and the ability to be administered orally, and might be optimal regimens in the future. Factors affecting the efficacy of anti-HCV treatments based on IFN-α include the HCV genotype, baseline viral load, virological response during treatment, host IL28B gene polymorphisms and hepatic steatosis. However, determining the effect of the above factors on DAA
therapy is necessary. In this review, we summarize the development of anti-HCV agents and assess the main factors affecting the efficacy of
antiviral treatments.