Perspectives on HCV: Current Therapeutic Regimens and Drug-Drug Interactions

Approximately 170 million people harbor chronic infection with hepatitis C virus (HCV) worldwide, with 3-4 million in the United States. As recently as 2013, the few treatment options available were poorly tolerated and only moderately effective. That changed when the first interferon-free direct-acting antiviral (DAA) regimen was US Food and Drug Administration-approved in December 2013. There are now 10 approved DAAs, with several more deep in the pipeline to approval. There are now interferon-free regimens available for every HCV genotype, and the application of DAA combination regimens has lifted response rates for historically difficult-to-treat patient groups to levels on par with more conventional treatment groups, including persons with HIV/HCV coinfection. This review will summarize the data behind currently recommended DAA regimens, review the data for treatment of HIV/HCV-coinfected patients, and discuss important drug-drug interactions between HCV DAAs and HIV antiretrovirals.