A pill for HCV - myth or foreseeable future?

作者：Jaroszewicz Jerzy; Flisiak Robert^*; Dusheiko Geoffrey

来源：Liver International, 2014, 34(1): 6-11.

DOI：10.1111/liv.12294

• HCV
• chronic hepatitis C
• direct-acting agents
• interferon
• IFN free
• IFN sparing

Weekly injections with pegylated-IFNa (PegIFN) combined with daily ribavirin (RBV) are still the standard of care for chronic hepatitis C in most of the world. Sustained virological response (SVR) of 40-50% for patients infected with HCV genotypes (GT) 1 or 4 and 70-90% for genotypes 2-3 are achieved with this regimen. Triple therapy, registered in both the EU and USA, utilizing the first-generation direct protease inhibitors is able to increase the SVR rates to 75%, but its use is restricted to patients infected with HCV GT1. Additional limitations include challenging dosing schedules, complex treatment algorithms, limited efficacy in patients with previous null response to PegIFN/RBV therapy and additional side effects. There is also an important need for more effective antiviral therapy for difficult-to-treat populations with PEG-IFN intolerance, particularly those with cirrhosis and non-responders to previous therapies. All-oral, IFN-free therapies are an evolutionary step for future anti-HCV therapies. Initial results of clinical studies conducted during the last year give hope for a pill for HCV' at least in selected CHC populations. In 2013 several clinical trials of all-oral anti-HCV therapies had been completed, first all-oral combination submitted for registration and some conclusions could be drawn. However, there is not yet a clear direction for IFN-free therapies in treatment naive patients or more complex non-responders.

• 出版日期2014-1