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Review
. 2018 Feb;38 Suppl 1(Suppl 1):7-13.
doi: 10.1111/liv.13673.

Treatment of hepatitis C virus infection with direct-acting antiviral agents: 100% cure?

Tarik Asselah  1 , Patrick Marcellin  1 , Raymond F Schinazi  2
Affiliations
Review

Treatment of hepatitis C virus infection with direct-acting antiviral agents: 100% cure?

Tarik Asselah et al. Liver Int. 2018 Feb.

Abstract

Around 71 million people are chronically infected with HCV worldwide. HCV antiviral drug development has been remarkable. The availability of pangenotypic direct-acting antivirals with excellent efficacy and good tolerability profiles offer a unique opportunity to achieve HCV elimination worldwide. IFN-free DAA combinations can now cure HCV in more than 95% of patients with HCV infection after 8-12 weeks of treatment. Programmes to eliminate HCV must include increased screening (risk-based and universal), linkage to care, as well as increased access to treatment worldwide. In this paper, we will review the available data on recently approved direct-acting antiviral agents, with sustained virological response that reaches almost 100%.

Keywords: HCV elimination; chronic hepatitis C; compliance; genotype; people who inject drugs; screening.

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Conflict of interest statement

CONFLICTS OF INTEREST

Tarik Asselah is a speaker and investigator for AbbVie, Bristol-Myers Squibb, Janssen, Gilead, Roche and Merck. Patrick Marcellin is a speaker for AbbVie, Bristol-Myers Squibb, Janssen, Gilead, Roche and Merck. Raymond Schinazi is the founder and major shareholder of Cocrystal Pharma, Inc.

Figures

FIGURE 1
FIGURE 1
(A) Direct-acting antiviral agents (DAAs) with different mode of actions. HCV is curable with many DAAs available that specifically target the HCV virus replication cycle to inhibit replication (NS3 protease inhibitors, nucleoside/nucleotide analogues and non-nucleoside inhibitors of the RNA-dependent RNA polymerase and NS5A inhibitors). (B) Development milestones of approved direct-acting antiviral agents. DCV, daclatasvir; DSV, dasabuvir; EBV, elbasvir; GLE, glecaprevir; GRZ, grazoprevir; LDV, ledipasvir; OMV, ombitasvir; PIB, pibrentasvir; PTV, paritaprevir; RTV, ritonavir; SMV, simeprevir; SOF, sofosbuvir; VEL, velpatasvir
FIGURE 2
FIGURE 2
(A) SOF/VEL SVR rates for 12 weeks across all genotypes (ASTRAL-1-2-3)., These studies encompassed a broad range of HCV populations, including HCV genotypes 1-6. The overall SVR rate in more than 1000 patients was high, with 98% achieving SVR12. AE, adverse event; D/C, discontinuation; LTFU, lost to followup; SAE, serious adverse event. (B) Sustained virological response rates overall and by cirrhosis or advanced fibrosis status. (ASTRAL-1-2-3). SVR12 was achieved by 98% of patients (490/501; 95% CI, 96-99). Patients with cirrhosis had an SVR12 rate of 96% (212/220), and those with advanced fibrosis had an SVR12 rate of 99% (278/281)
FIGURE 3
FIGURE 3
(A) Studies evaluating the efficacy of GLE/PIB in patients with HCV GT1, 2, 4-6 Infection with or without compensated cirrhosis. GLE/PIB for 8 weeks (Endurance-1 and Surveyor-2) in patients without cirrhosis resulted overall in an SVR of 98% (596/606); and for GT1 an SVR of 99% (348/351).(B) Studies evaluating the efficacy of GLE/PIB in patients with HCV GT3 infection with or without compensated cirrhosis. Genotype 3-infected patients treated for 12 weeks achieved an SVR12 rate of 95.3% with GLE/PIB, compared to a 96.5% SVR12 rate with SOF/DCV; 8-week GLE/PIB yielded an SVR12 rate of 94.9%
FIGURE 4
FIGURE 4
C-EDGE COSTAR: efficacy of 12 weeks GRZ/EBV in GT 1, 4 or 6 patients receiving OST. DAAs results in high rates of SVR in people who inject drugs; 92% (184/201) in the immediate treatment group. In this study, 0%-3% of patients discontinued treatment because of adverse events. Among 18 patients with post-treatment viral recurrence through 24-week follow-up, 6 had probable reinfection
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References

    1. Asselah T, Boyer N, Saadoun D, et al. Direct-acting antivirals for the treatment of hepatitis C virus infection: optimizing current IFN-free treatment and future perspectives. Liver Int. 2016;36(Suppl 1):47–57. - PubMed
    1. Schinazi RF. Asselah T. From HCV to HBV cure. Liver Int. 2017;37(Suppl1):73–80. - PMC - PubMed
    1. Martinot-Peignoux M, Stern C, Maylin S, et al. Twelve weeks post treatment follow-up is as relevant as 24 weeks to determine the sustained virologic response in patients with hepatitis C virus receiving pegylated interferon and ribavirin. Hepatology. 2010;51:1122–1126. - PubMed
    1. Maylin S, Martinot-Peignoux M, Moucari R, et al. Eradication of hepatitis C virus in patients successfully treated for chronic hepatitis C. Gastroenterology. 2008;135:821–829. - PubMed
    1. Afdhal N, Everson GT, Calleja JL, et al. Effect of viral suppression on hepaticvenous pressure gradient in hepatitis C with cirrhosis and portal hypertension. J Viral Hepat. 2017;24:823–831. - PubMed

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