Advances in Treatment of Hepatitis C

Abstract

Hepatitis C infection (HCV) is a major cause of chronic hepatitis and cirrhosis worldwide. Interferon-based regimen has been the sole therapy to eradicate HCV infection for decades. However, this interferon and ribavirin combination is associated with several serious adverse events and the sustained virologic response rate was suboptimal. The recent discovery of oral direct-acting antiviral agents (DAAs) heralded a revolution in the treatment of chronic HCV. This breakthrough in HCV resulted in high rates of HCV eradication with sustained virologic response rates ranging between 90 and 100% across different genotypes. New therapies were administered orally for 12 or 24 months and this resulted in better compliance and few adverse events. DAAs are categorized into four major groups namely: NS5B nucleotide inhibitors, NS5B nonnucleoside inhibitors, NS5A replication complex inhibitors, and NS3/4A protease inhibitors (PI). Several interferonfree regimens have been approved and adequately assessed and several new regimens with high potencies, less cross-resistance, and better safety profile are in the process of approval. Thus, the era of HCV eradication and cure has begun.

Avaliação da eficácia, tolerabilidade e desenvolvimento de resistência com o uso dos antivirais de ação direta no tratamento da hepatite C em indivíduos infectados pelo HIV

“…Cerca de 25% dos pacientes coinfectados que iniciavam tratamento com IFN necessitavam descontinuar precocemente as medicações por razões médicas (efeitos colaterais, interações medicamentosas, não resposta, falha na adesão) 34,35,36,37,38 . 40,41,42 .…”