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Review
. 2017 Feb 17:10:39-52.
doi: 10.2147/IJGM.S127689. eCollection 2017.

Hepatitis C treatment: where are we now?

Nicholas J Burstow  1 , Zameer Mohamed  1 , Asmaa I Gomaa  2 , Mark W Sonderup  3 , Nicola A Cook  1 , Imam Waked  2 , C Wendy Spearman  3 , Simon D Taylor-Robinson  1
Affiliations
Review

Hepatitis C treatment: where are we now?

Nicholas J Burstow et al. Int J Gen Med. .

Abstract

Chronic hepatitis C infection affects millions of people worldwide and confers significant morbidity and mortality. Effective treatment is needed to prevent disease progression and associated complications. Previous treatment options were limited to interferon and ribavirin (RBV) regimens, which gave low cure rates and were associated with unpleasant side effects. The era of direct-acting antiviral (DAA) therapies began with the development of first-generation NS3/4A protease inhibitors in 2011. They vastly improved outcomes for patients, particularly those with genotype 1 infection, the most prevalent genotype globally. Since then, a multitude of DAAs have been licensed for use, and outcomes for patients have improved further, with fewer side effects and cure rates approaching 100%. Recent regimens are interferon-free, and in many cases, RBV-free, and involve a combination of DAA agents. This review summarizes the treatment options currently available and discusses potential barriers that may delay the global eradication of hepatitis C.

Keywords: directly acting antivirals; hepatitis C; hepatitis C eradication; interferon-free regimens; protease inhibitors; ribavirin-free regimens.

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Conflict of interest statement

Disclosure SDT-R holds grants from the UK Medical Research Council and the Wellcome Trust (London, UK). The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Genotype 1 is the most common cause of chronic hepatitis C infection worldwide. Reproduced from Messina JP, Humphreys I, Flaxman A, et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology. 2015;61(1):77–87. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode. Abbreviation: HCV, hepatitis C virus.
Figure 2
Figure 2
Distribution of GT1a versus GT1b. Reproduced from Messina JP, Humphreys I, Flaxman A, et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology. 2015;61(1):77–87. Creative Commons license and disclaimer available from: http://creativecommons.org/licenses/by/4.0/legalcode. Abbreviations: GT, genotype; HCV, hepatitis C virus.
Figure 3
Figure 3
Hepatitis C virus polyprotein structure. Abbreviation: HCV, hepatitis C virus.
See this image and copyright information in PMC

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