The hepatitis C revolution part 1: antiviral treatment options.

Abstract

PURPOSE OF REVIEW:

The rapid evolution in the therapeutic landscape of hepatitis C presents a minefield to clinicians seeking to optimize therapy for their patients. Efficacy, evidence-base, side-effects, and drug combinations must be tailored to individual patients, taking into account comorbidities, degree of fibrosis, evidence of hepatic decompensation, and life expectancy. The review article aims to discuss novel hepatitis C virus (HCV) treatments with an overview of recent breakthrough research validating their potential. It is hoped that this systematic evaluation will clarify best available evidence for clinicians treating patients with HCV on a regular basis.

RECENT FINDINGS:

With greater understanding of the HCV life cycle and viral genome, the last decade has seen the emergence of novel direct-acting antiviral (DAA) agents, which specifically target proteins responsible for viral replication. Landmark clinical trials have offered robust evidence supporting the use of DAA agents as pioneer treatments, alone, or in combination with standard pegylated interferon (peg-IFN) and ribavirin (RBV)-based regimens. DAAs have proved highly efficacious, with pan-genotypic activity, shortened treatment duration, and an improved side-effect profile when compared with historical peg-IFN/RBV treatment. Recent phase 3 studies have provided proof-of-concept that all-oral, IFN-free DAA regimens can yield high rates of sustained virological response across most HCV genotypes.

SUMMARY:

The ability of DAAs to dramatically improve virological clearance heralds a new era in clinical therapeutics, as the unprecedented prospect of cure for a chronic viral infection becomes tangible. However, myriad clinical challenges remain before global eradication of HCV can become reality.

• Authors: Prarthana Thiagarajan, Stephen D Ryder
• Journal: Current opinion in infectious diseases (Curr Opin Infect Dis) Vol. 28 Issue 6 Pg. 563-71 (Dec 2015) ISSN: 1473-6527 [Electronic] United States
• PMID: 26524328 (Publication Type: Journal Article, Review)

Chemical References

• Antiviral Agents
• Interferon alpha-2
• Interferon-alpha
• Recombinant Proteins
• Polyethylene Glycols
• Ribavirin
• peginterferon alfa-2b

Topics

• Antiviral Agents (therapeutic use)
• Comorbidity
• Drug Therapy, Combination
• Evidence-Based Medicine
• Genotype
• Hepacivirus (drug effects, genetics)
• Hepatitis C, Chronic (drug therapy, genetics)
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Polyethylene Glycols (therapeutic use)
• Practice Guidelines as Topic
• Recombinant Proteins (therapeutic use)
• Ribavirin (therapeutic use)
• Treatment Outcome