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Dynamic evolution of therapy for chronic hepatitis C: how will novel agents be incorporated into the standard of

Stefan Zeuzem1, David R Nelson, Patrick Marcellin

  • 1JW Goethe University Hospital, Frankfurt, Germany. Zeuzem@em.uni-frankfurt.de

Antiviral Therapy
|October 9, 2008
PubMed

Insights

New therapies are needed to improve cure rates for chronic hepatitis C virus (HCV) infection. Current research focuses on novel agents combined with pegylated interferon (PEG-IFN) and ribavirin to enhance treatment efficacy.

Area of Science:

  • Hepatology and Viral Gastroenterology
  • Pharmacology and Drug Development

Background:

  • Chronic hepatitis C virus (HCV) infection requires improved treatment strategies to increase cure rates.
  • Current standard of care involves pegylated interferon (PEG-IFN) plus ribavirin, with ongoing trials to optimize outcomes.

Purpose of the Study:

  • To evaluate the potential of new anti-HCV agents to augment or compensate for the limitations of the current standard of care.
  • To explore novel therapeutic agents that can suppress viral replication and clear infected hepatocytes for improved cure rates.

Main Methods:

  • Investigation of a broad spectrum of new anti-HCV agents, including NS3/4A protease inhibitors and polymerase inhibitors.
  • Clinical trials assessing the efficacy of these new agents in combination with PEG-IFN plus ribavirin in treatment-naive patients.

Main Results:

  • Reductions in serum HCV RNA levels of 2 to 5 log10 IU/ml observed with protease and polymerase inhibitors.
  • Additive reductions in HCV RNA seen when new agents are combined with PEG-IFN plus ribavirin in treatment-naive individuals.
  • Preliminary results in patients non-responsive to interferon are less promising.

Conclusions:

  • New anti-HCV agents are expected to increase cure rates, shorten therapy duration, improve tolerability, and simplify treatment regimens.
  • Combinations of small molecules will likely be necessary for sustained HCV replication suppression, with large trials several years away.
  • The treatment paradigm for chronic hepatitis C is evolving to incorporate newly approved drugs.

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