Abstract
Therapy for hepatitis C has been fairly stagnant for the past decade, but the past few years have seen major progress and evolution, beginning with the approval of two HCV protease inhibitors in 2011. In spite of considerable improvements in response rates with these agents, a need for additional agents with improved potency and tolerability remains. Toward this goal and over the course of just a few months, the HCV therapy pipeline has already become crowded with direct-acting antivirals, host-targeted agents and unique interferons, all of which are positioned to be part of the next wave of therapeutic options. The ultimate goal of this push for new agents is to achieve a safe and straight forward yet highly effective therapy for hepatitis C that is widely embraced and readily available. Particularly among the 'baby boomer' population, it is predicted that over the next few years, more patients with currently quiescent infections will be newly diagnosed, and those currently diagnosed will be at increased risk of long-term complications of infection, and thus in need of treatment. A simple and safe treatment paradigm will become a necessity. This Review chronicles the latest developments in hepatitis C therapy and the potential effect these new treatments could have on delivery of care to patients infected with HCV.
Key Points
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Continued investigation into direct-acting antiviral therapy, new host factor targets and novel interferons for HCV is proceeding rapidly and should lead to simpler therapies with improved cure rates soon
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People born 1945–1964 comprise a large proportion of infected patients (mostly undiagnosed) and are targeted for screening in new initiatives recommended by the Centers for Disease Control and Prevention
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In the USA, an estimated 800,000 new patients with HCV will be diagnosed through this plan in the next few years, further increasing the need for an effective linkage to care
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A goal of future therapies for HCV is ideally an interferon-free, short-duration, highly effective and well-tolerated treatment to expand the pool of treated patients
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New therapies with improved safety and effectiveness will hopefully also enable a broader treatment-delivery cohort—including gastroenterologists, primary care physicians and infectious disease specialists—to treat the increasing population of patients
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Change history
07 August 2013
In the version of this article originally published online and in print, a finding was listed incorrectly in Table 6. The error has been corrected for the HTML and PDF versions of the article.
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D. M. Jensen is a consultant for Abbott, Astex, Biotica, Boehringer-Ingelheim, Bristol Myers Squibb, Genentech, Gilead, Janssen, Merck and Vertex and a clinical research investigator for Abbott, Boehringer-Ingelheim, Bristol Myers Squibb, Genentech, Gilead and Janssen. N. M. Dabbouseh declares no competing interests.
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Dabbouseh, N., Jensen, D. Future therapies for chronic hepatitis C. Nat Rev Gastroenterol Hepatol 10, 268–276 (2013). https://doi.org/10.1038/nrgastro.2013.17
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