Therapy of chronic hepatitis C virus infection in the era of direct-acting and host-targeting antiviral agents

J Infect. 2014 Jan;68(1):1-20. doi: 10.1016/j.jinf.2013.08.019. Epub 2013 Sep 4.

Abstract

Objectives: Chronic hepatitis C virus (HCV) infection represents a leading worldwide medical and social problem. The expanding knowledge of HCV lifecycle has led to the development of novel antiviral agents that: a) specifically target a viral function (direct-acting antivirals), or b) specifically inhibit viral replication. The present review describes the novel anti-HCV drugs that have been better studied at the time of this writing and the current two types of treatment, namely interferon-based and interferon-free regimens. In addition, predictive factors, virological responses, side-effects, and resistance mechanisms of the novel agents are summarized.

Conclusions: The introduction of novel antiviral agents is remarkably changing the therapeutic combinations aimed at improving virological responses both for easy-to-cure and difficult-to-treat patients. Since additional, effective drugs are under advanced development, it seems reasonable to expect that further therapeutic and prognostic improvements will be achieved in the near future.

Keywords: BOC; CHC; CV; Chronic hepatitis C; DAA; DVR; Direct-acting antivirals; EVR; HCV; HTAs; Host-targeting antivirals; IFN-α; IL28B; ISGs; Interferon; NIs; NNIs; PI; Protease inhibitors; RBV; RGR; RVR; Ribavirin; SNP; SVR; SoC; TPV; boceprevir; chronic hepatitis C; cryoglobulinemic vasculitis; delayed virological response; direct-acting antiviral; eRVR; early virological response; extended rapid virological response; genotype; genotypes; gt; gts; hepatitis C virus; host-targeting antivirals; interferon-alpha; interferon-stimulated genes; interleukin 28B; non-nucleoside inhibitors; nucleoside analog inhibitors; pIFN; pegylated interferon; protease inhibitor; rapid virological response; response-guided regimens; ribavirin; single nucleotide polymorphism; standard of care; sustained virological response; telaprevir.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Drug Delivery Systems
  • Hepacivirus / drug effects*
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferon-alpha / pharmacology
  • Interferon-alpha / therapeutic use
  • Protease Inhibitors / pharmacology
  • Protease Inhibitors / therapeutic use

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Protease Inhibitors