Optimal therapy in genotype 4 chronic hepatitis C: finally cured?

Optimal therapy for patients with hepatitis C virus (HCV) genotype 4 (HCV‐4) infection is changing rapidly, and the possibility of a total cure is near. The standard of care has been combination pegylated interferon (PEG‐IFN)‐ribavirin (RBV), with modest response rates and considerable adverse event...

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Bibliographic Details
Published in:Liver international 2015-01, Vol.35 (s1), p.27-34
Main Authors: Abdel-Razek, Wael, Waked, Imam
Format: Article
Language:English
Subjects:
Carbamates
direct acting antivirals
Drug Therapy, Combination - methods
Drug Therapy, Combination - trends
Genotype
genotype 4
Hepacivirus - drug effects
Hepacivirus - genetics
hepatitis C
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - genetics
Heterocyclic Compounds, 3-Ring - therapeutic use
Humans
Imidazoles - therapeutic use
Interferon-alpha - therapeutic use
interferon-free regimens
Polyethylene Glycols - therapeutic use
Pyrrolidines
Recombinant Proteins - therapeutic use
Ribavirin - therapeutic use
Simeprevir
Sofosbuvir
Sulfonamides - therapeutic use
Uridine Monophosphate - analogs & derivatives
Uridine Monophosphate - therapeutic use
Valine - analogs & derivatives
Viral Nonstructural Proteins - antagonists & inhibitors
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Summary:Optimal therapy for patients with hepatitis C virus (HCV) genotype 4 (HCV‐4) infection is changing rapidly, and the possibility of a total cure is near. The standard of care has been combination pegylated interferon (PEG‐IFN)‐ribavirin (RBV), with modest response rates and considerable adverse events. Since the introduction of sofosbuvir (SOF), simeprevir (SIM), and daclatasvir (DCV), the duration of treatment has been significantly shortened and response rates have increased. The recommended treatment for IFN‐eligible patients is PEG‐IFN/RBV plus SOF, SIM or DCV. In IFN ineligible patients, the optimal regimen is a 24‐week course of SOF/RBV, or a 12‐week course of SOF‐SIM or SOF‐DCV with or without RBV. The pipeline for patients with chronic HCV is highly active. IFN‐free combinations with paritaprevir‐ombitasvir, SOF‐ledipasvir, or DCV‐asunaprevir (ASV)‐beclabuvir (BMS‐791325) for 12 weeks or less with close to 100% cure rates will soon become the optimal therapy.
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.12724