Until recently, the standard of care (SOC) for patients with chronic hepatitis C virus (HCV) infection has consisted of a combination of pegylated interferon-N1 plus ribavirin, administered for 24- to 48-weeks depending on the HCV genotype. The sustained virologic response rate for this SOC has been only about 50% in patients infected with genotype 1 HCV, the most prevalent genotype in Europe and North America. HCV therapy has been revolutionised recently by the approval of two direct-acting antiviral agents (DAA) against the NS3/4A serine protease for use in genotype 1 HCV, the ketoamide inhibitors boceprevir and telaprevir. The novel SOC marks the beginning of an extraordinary new era in HCV therapy. We review this new SOC with an emphasis on practical issues related to protease inhibitors, e.g. prescribing guidelines, futility rules and management of adverse events. We also give a perspective on what to expect in the coming years. Newer DAA with simplified dosing regimens and/or minimal toxicity which, when used in combination, will lead to viral eradication in most if not all CHC patients who undergo treatment. The novel agents in clinical development are paving the way for future interferon-sparing regimens.
- Antiviral therapy
- hepatitis C
- new standard of care
- protease inhibitor
Statistics from Altmetric.com
Competing interests SZ has served as a consultant for Abbott, Achillion, Anadys, BMS, Boehringer, Gilead, iTherX, Janssen, Merck, Novartis, Pfizer, Pharmasset, Roche, Santaris, Tibotec and Vertex. IMJ has served as a consultant for Abbott, Achillion, Boehringer-Inghelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen/Tibotec, Merck, Novartis, Pfizer, Pharmasset, Roche/Genentech and Vertex, and as a speaker for Bristol-Myers Squibb, Gilead, Merck and Vertex. The remaining authors disclose no competing interests.
Provenance and peer review Commissioned; externally peer reviewed.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.