Current prospects for interferon-free treatment of hepatitis C in 2012

Present interferon‐based therapy for chronic hepatitis C is limited by both efficacy and tolerability. Telaprevir and boceprevir are the first two direct‐acting antiviral drugs (DAAs) that inhibit hepatitis C virus replication to be licensed for use in conjunction with pegylated interferon and ribav...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2013-01, Vol.28 (1), p.38-45
Main Author: Stedman, Catherine AM
Format: Article
Language:English
Subjects:
Antiviral agents
Antiviral Agents - therapeutic use
Clinical trials
Clinical Trials as Topic
Cyclophilins - antagonists & inhibitors
Development
direct-acting antivirals
Drug Resistance, Viral
Drug Therapy, Combination - adverse effects
Enzyme Inhibitors - therapeutic use
Genotypes
Hepacivirus - genetics
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - drug therapy
Humans
Interferon
interferon-free
Interferons - therapeutic use
Replication
Ribavirin
Ritonavir
Viral Nonstructural Proteins - antagonists & inhibitors
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Summary:Present interferon‐based therapy for chronic hepatitis C is limited by both efficacy and tolerability. Telaprevir and boceprevir are the first two direct‐acting antiviral drugs (DAAs) that inhibit hepatitis C virus replication to be licensed for use in conjunction with pegylated interferon and ribavirin. Numerous other DAAs are in clinical development, and phases 2 and 3 trials are evaluating interferon‐free combination DAA therapy. Interferon‐free sustained virologic responses have now been achieved with combinations of asunaprevir and daclatasvir; sofosbuvir and ribavirin; sofosbuvir and daclatasvir; faldaprevir and BI207127; ABT‐450, ritonovir and ABT‐333; ABT‐450, ritonovir and ABT‐072; miracitabine, danoprevir and ritonavir; and alisporivir and ribavirin. Some drugs are genotype‐specific in their activity, whereas others are pan‐genotypic, and differential responses for the genotype 1 subtypes 1a and 1b have emerged with many DAA combinations. Viral breakthrough and resistance are important considerations for future trial design. The prospect of interferon‐free combination DAA therapy for hepatitis C virus is now finally becoming a reality.
ISSN:0815-9319
1440-1746
DOI:10.1111/jgh.12028