Gut Liver.  2014 Sep;8(5):471-479. 10.5009/gnl14083.

Emerging Therapies for Hepatitis C

• Kim DY
• Ahn SH
• Han KH

• KMID: 2070056
• DOI: http://doi.org/10.5009/gnl14083

Abstract

The combination of pegylated interferon (PEG-IFN) and ribavirin (RBV), the current therapy for hepatitis C virus (HCV) infection, has saved the lives of many HCV-infected patients. Direct-acting antivirals (DAAs) target several sites of HCV nonstructural proteins, resulting in the cessation of viral replication. The first NS3/4A protease inhibitors consisted of boceprevir and telaprevir, which have shown superior efficacy against genotype 1 HCV infection when combined with PEG-IFN/RBV compared with the standard therapy in both treatment-naive and -experienced patients. Simeprevir, faldaprevir, and asunaprevir are second-wave, first-generation NS3/4A inhibitors that have already been or will soon be approved. Second-generation protease inhibitors are in clinical trials. Daclatasvir is the first approved DAA belonging to the class of NS5A replication complex inhibitors. The potency of daclatasvir is very high, and this drug is an important and essential component of combination regimens for all genotypes. Sofosbuvir, the first approved NS5B polymerase inhibitor, is characterized by high potency and genetic barriers to resistance. Sofosbuvir combined with RBV achieved an interferon-free regimen in genotype 2 or 3 patients with a reduced treatment duration. It can also be used in combination with PEG-IFN/RBV in genotype 1 patients for 12 weeks. DAAs have provided new hope for curing HCV infections with a short treatment duration and acceptable adverse events.

Keyword

Hepatitis C; Direct acting antiviral; Pegylated interferon; Ribavirin

MeSH Terms

Antiviral Agents/*therapeutic use
Drug Therapy, Combination
Hepacivirus/drug effects/genetics
Hepatitis C/*drug therapy
Humans
Protease Inhibitors/therapeutic use
Viral Nonstructural Proteins/antagonists & inhibitors
Virus Replication/drug effects
Antiviral Agents
Protease Inhibitors
Viral Nonstructural Proteins