Abstract
Introduction:
About 2.35% of the world population can be infected with hepatitis C virus (HCV) responsible for chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Currently available interferon-based medication is successful in up to 75% of the patients infected with HCV genotypes 1, 2 or 3 and lower efficacy in other genotypes. Unfortunately sustained virologic response (SVR) rate in genotype 1 infected non-responders to previous therapy with advanced hepatic fibrosis even after retreatment with the first generation direct acting antivirals (DAA) is about 40% only.
Areas covered:
The second generation DAA, which have recently been submitted for registration (Sofosbuvir and Simeprevir) still need combination with PegIFNα and RBV in patients infected with HCV genotype 1. There is a need for more effective antiviral therapy for difficult to treat patients who are interferon intolerant, developed liver cirrhosis or non-responders to previous therapies. Therefore, IFN-free regimens are step for future therapies consisting of combinations of novel investigational DAA and host targeting agents.
Expert opinion:
The introduction of novel DAA with a good safety profile and high barrier to resistance can lead to SVR rates exceeding 90% in treatment naïve patients and non-responders to previous therapy infected with different genotypes.
MeSH terms
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Antiviral Agents / administration & dosage
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Antiviral Agents / adverse effects
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Antiviral Agents / therapeutic use*
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Clinical Trials as Topic
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Drug Discovery
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Drug Therapy, Combination
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Hepacivirus / drug effects
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Hepacivirus / genetics
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Hepacivirus / isolation & purification
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Hepatitis C / drug therapy*
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Hepatitis C / virology
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Heterocyclic Compounds, 3-Ring / administration & dosage
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Heterocyclic Compounds, 3-Ring / adverse effects
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Heterocyclic Compounds, 3-Ring / therapeutic use
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Humans
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Interferon alpha-2
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Interferon-alpha / administration & dosage
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Interferon-alpha / adverse effects
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Interferon-alpha / therapeutic use
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Polyethylene Glycols / administration & dosage
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Polyethylene Glycols / adverse effects
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Polyethylene Glycols / therapeutic use
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Recombinant Proteins / administration & dosage
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Recombinant Proteins / adverse effects
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Recombinant Proteins / therapeutic use
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Ribavirin / administration & dosage
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Ribavirin / adverse effects
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Ribavirin / therapeutic use
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Simeprevir
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Sofosbuvir
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Sulfonamides / administration & dosage
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Sulfonamides / adverse effects
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Sulfonamides / therapeutic use
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Uridine Monophosphate / administration & dosage
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Uridine Monophosphate / adverse effects
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Uridine Monophosphate / analogs & derivatives
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Uridine Monophosphate / therapeutic use
Substances
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Antiviral Agents
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Heterocyclic Compounds, 3-Ring
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Interferon alpha-2
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Interferon-alpha
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Recombinant Proteins
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Sulfonamides
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Polyethylene Glycols
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Ribavirin
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Simeprevir
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Uridine Monophosphate
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peginterferon alfa-2b
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peginterferon alfa-2a
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Sofosbuvir