New antiviral therapies for chronic hepatitis C

Kanda, Tatsuo; Imazeki, Fumio; Yokosuka, Osamu

doi:10.1007/s12072-010-9193-3

Cited by 100 publications

(117 citation statements)

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“…In vitro inhibition of NS4B has been shown to compromise HCV replication significantly. NS5A protein contributes in the regulation of HCV replication [120] . No clinical data on resistance to these compounds have been reported, and thus, results studies using multiple dose and combination therapy have to be awaited.…”

Section: Compounds Targeting Hcv Replicationmentioning

confidence: 99%

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

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Hepatitis C virus (HCV) is a major health problem that leads to chronic hepatitis, cirrhosis and hepatocellular carcinoma, being the most frequent indication for liver transplantation in several countries. Unfortunately, HCV re-infects the liver graft almost invariably following reperfusion, with an accelerated history of recurrence, leading to 10%-30% of patients progressing to cirrhosis within 5 years of transplantation. In this sense, some groups have even advocated for not retransplanting this patients, as lower patient and graft outcomes have been reported. However, the management of HCV recurrence is being optimized and several strategies to reduce post-transplant recurrence could improve outcomes, decrease the rate of re-transplantation and optimize the use of available grafts. Three moments may be the focus of potential actions in order to decrease the impact of viral recurrence: the pretransplant moment, the transplant environment and the post-transplant management. In the pre-transplant setting, it is not well established if reducing the pre transplant viral load affects the risk for HCV progression after transplant. Obviously, antiviral treatment can render the patient HCV RNA negative post transplant but the long-term benefit has not yet been fully established to justify the cost and clinical risk. In the transplant moment, factors as donor age, cold ischemia time, graft steatosis and ischemia/reperfusion injury may lead to a higher and more aggressive viral recurrence. After the transplant, discussion about immunosuppression and the moment to start the treatment (prophylactic, pre-emptive or once-confirmed) together with new antiviral drugs are of interest. This review aims to help clinicians have a global overview of posttransplant HCV recurrence and strategies to reduce its impact on our patients.

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Section: Compounds Targeting Hcv Replicationmentioning

confidence: 99%

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

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“…The goal of therapy in chronic HCV infection is to achieve SVR and thereby prevent long-term complications. Despite the promising role of new antiviral therapies [11] , the use of pegylated-interferon alfa combined with ribavirin continues, to date, to be the standard care of treatment in HCV infection.…”

Section: Discussionmentioning

confidence: 99%

Pegylated interferon alfa-2b plus ribavirin for treatment of chronic hepatitis C

Rao

Koshy

Philip

et al. 2014

WJH

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AIM:To study the safety and efficacy of pegylated interferon alfa-2b, indigenously developed in India, plus ribavirin in treatment of hepatitis C virus (HCV). METHODS:One-hundred HCV patients were enrolled in an open-label, multicenter trial. Patients were treated with pegylated interferon alfa-2b 1.5 μg/kg per week subcutaneously plus oral ribavirin 800 mg/d for patients with genotypes 2 and 3 for 24 wk. The same dose of peginterferon plus weight-based ribavirin (800 mg/d for ≤ 65 kg; 1000 mg/d for > 65-85 kg; 1200 mg/d for > 85-105 kg; 1400 mg/d for > 105 kg body weight) was administered for 48 wk for patients with genotypes 1 and 4. Serological and biochemical responses of patients were assessed. RESULTS:Eighty-two patients (35 in genotypes 1 and 4 and 47 in 2 and 3), completed the study. In genotype 1, 25.9% of patients achieved rapid virologic response (RVR): while the figures were 74.1% for early virologic response (EVR) and 44.4% for sustained virologic response (SVR). For genotypes 2 and 3, all patients bar one belonged to genotype 3, and of those, 71.4%, 87.5%, and 64.3% achieved RVR, EVR, and SVR, respectively. In genotype 4, 58.8%, 88.2%, and 52.9% of patients achieved RVR, EVR, and SVR, respectively. The majority of patients attained normal levels of alanine aminotransferase by 4-12 wk of therapy. Most patients showed a good tolerance for the treatment, although mild-to-moderate adverse events were exhibited; only two patients discontinued the study medication due to serious adverse events (SAEs). Eleven SAEs were observed in nine patients; however, only four SAEs were related to study medication. CONCLUSION:Peginterferon alfa-2b, which was developed in India, in combination with ribavirin, is a safe and effective drug in the treatment of HCV.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Hepatitis C virus; Genotype; Peginterferon alfa-2b; Ribavirin; Treatment Core tip: In a multicenter study, the safety and efficacy of pegylated interferon alfa-2b, indigenously developed CLINICAL TRIALS STUDYSubmit a

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“…In Japan, as many people live to an advanced age [18] , HCV-infected patients are also growing older [16,17,19] . Peginterferon-alpha plus ribavirin may lead to a approximately 50% SVR and approximately 80% SVR, respectively, in HCV genotype 1 treated for 48-72 wk and genotype 2-infected Japanese patients treated for 24 wk [14] . In male and female HCV genotype 1-infected patients aged ≥ 65 years and treated with peginterferon-alpha plus ribavirin, an SVR was achieved in 54.8% and 29.5%, respectively [18] .…”

Section: Recent Trends In Hcv-infected Patients In Japanmentioning

confidence: 98%

“…Interferon therapy can reduce the risk for HCC [10] and improve liver fibrosis [11] if patients with chronic hepatitis C achieve a sustained virological response (SVR) to this therapy [12,13] . In the direct-acting antivirals (DAAs) against HCV era, peginterferon-alpha plus ribavirin therapy with or without DAAs, as well as interferon-free regimens, led to the higher SVR rates in patients infected with HCV [14,15] . However, these treatments also had disadvantages due to specific adverse events.…”

Section: Carcinomamentioning

confidence: 99%