Update on hepatitis C: epidemiology, treatment and resistance to antiviral therapies

Chronic hepatitis C (HCV) is a major cause of morbidity and mortality due to chronic liver disease worldwide. Exposure to the virus leads to chronic infection in the majority of cases and may be associated with progression to cirrhosis, end-stage liver disease and hepatocellular carcinoma. Treatment of HCV has been challenging until recently, requiring combination treatment with interferon injections and ribavirin, both associated with significant toxicities and sustained virologic response (SVR) rates of 50% for most patients. Recent advances in therapy have allowed for all-oral treatments with SVR rates >90% with as little as 8 weeks of therapy. This review describes the developments in HCV therapy over the last two decades, the current treatment regimens and the rates of antiviral resistance with the new therapies on the horizon.