Comparative Study of IFN-Based Versus IFN-Free Regimens and Their Efficacy in Treatment of Chronic Hepatitis C Infections

Abstract

The hepatitis C viral (HCV) infection is a global health burden, WHO estimates 130-150 million people chronically infected with hepatitis C virus worldwide. Additional 3-4 million people become newly infected annually and more than 350,000 people die each year of HCV-related liver diseases. HCV infection exhibits higher genetic diversity with regional variations in genotypic prevalence resulting big challenges on disease management. Introduction of DAAs revolutionised the new era of all oral therapy in treatment of chronic hepatitis C infection and is the regimens of choice in present days. However, IFN-based combination therapy with sofosbuvir has promising efficacy in genotypes 3, 4, 5 or 6 infections compared to genotypes 1 and 2 infections. So, these regimens could be an option in DAAs regimen failure cases. The poor availability of data on recent DAAs (IFN-free) regimens questioned on regular use and cost effectiveness is the another challenge with DAAs regimens. So phase III trials (sofosbuvir and velpatasvir) of recent DAAs with pangenotypic actions and better tolerability in HCV infected patients are the future advances in treatment of chronic hepatitis C. After all those recent combination therapies with better SVR, the combination of pegylated interferon with ribavirin is the only option available where unavailability of other regimens still exists.

Hepatitis C Virus Infection in Pregnancy and Children: Its Implications and Treatment Considerations with Directly Acting Antivirals: A Review

“…19 The spontaneous remission in acute infection is about 15-45% in 6 months duration whereas approximately 55-85% progress to a chronic state which may be diagnosed during screening or patients present with complications such as liver failure, cirrhosis, and hepatocellular carcinoma (HCC). 5,11,45 In general, the infection does not impact the clinical course of pregnancy in the absence of cirrhosis; however, there are reports of prematurity, low birth weight, antepartum hemorrhage, pre-eclampsia, and microcephaly. 9,14,17,46,47 Gestational diabetes and gestational hypertension are common in HCV carriers; however, there was a decreased risk of preeclampsia shown by the Swedish population-based cohort study.…”

“…[1][2][3] GT 1-3 are globally prevalent while GTs 4, 5, and 6 are localized in Northern Africa, South Africa, and Asia, respectively. 2,[4][5][6] Approximately 170 million people are HCV infected globally, 8% of pregnant women, pose a significant risk in development of liver cirrhosis (27%) and hepatocellular carcinoma (25%). 3,[7][8][9][10][11][12][13] Particularly, women have a higher infections risk; about 40% of reproductive age group.…”