[Antiviral therapy for chronic hepatitis C: current status and perspectives]

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Chronic hepatitis C (HCV) treatment has evolved since the 1990s, with initial interferon monotherapy showing limited efficacy.
• Current standard therapy involves combination treatment with pegylated interferon and ribavirin, offering improved, yet variable, response rates based on HCV genotype.
• Hepatitis C poses significant risks, including progression to liver cirrhosis and hepatocellular carcinoma, underscoring the importance of effective antiviral therapy.

Purpose of the Study:

• To review the advancements in antiviral therapy for chronic hepatitis C.
• To highlight the efficacy of current combination therapies and predictors of treatment success.
• To emphasize the need for novel therapeutic agents and the critical role of antiviral treatment in preventing liver-related mortality.

Main Methods:

• Review of historical and current antiviral treatment regimens for chronic hepatitis C.
• Analysis of sustained virologic response rates for different treatment durations and HCV genotypes.
• Discussion of early viral kinetics as a predictor for treatment response and duration adjustment.

Main Results:

• Interferon monotherapy achieved only 5% sustained virologic response in difficult-to-treat genotype 1 patients.
• Combination therapy yields 40-50% response for genotype 1 (48 weeks) and 80% for genotype 2 (24 weeks).
• Early viral kinetics predicts sustained virologic response, guiding extended 72-week therapy recommendations for genotype 1.

Conclusions:

• Antiviral therapy for chronic hepatitis C has made substantial progress, improving patient outcomes.
• While current therapies are effective, particularly for genotype 2, novel agents are essential for non-responsive patients.
• Effective antiviral treatment is crucial for mitigating liver disease progression and reducing liver-related deaths in HCV-infected individuals.