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Direct-acting antivirals: the endgame for hepatitis C?
Roberta D'Ambrosio1, Elisabetta Degasperi1, Massimo Colombo2
1Division of Gastroenterology and Hepatology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
Current Opinion in Virology
|April 19, 2017
Summary
Directly-acting antivirals (DAA) offer a potential cure for chronic hepatitis C (HCV) infection. These interferon-free regimens achieve nearly 95% efficacy, paving the way for HCV elimination.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Chronic hepatitis C (HCV) infection was historically difficult to treat.
- Interferon (IFN)-based therapies had significant limitations and contraindications.
Purpose of the Study:
- To summarize the efficacy and impact of directly-acting antivirals (DAA) in treating chronic hepatitis C.
- To highlight the advancements in all-oral, IFN-free treatment regimens.
Main Methods:
- Review of DAA classes: protease inhibitors (anti-NS3/4A), RNA-dependent polymerase inhibitors (anti-NS5B), and anti-NS5A inhibitors.
- Analysis of treatment schedules based on HCV genotype and liver disease stage.
- Evaluation of treatment duration (12-24 weeks) and overall efficacy.
Main Results:
- DAA regimens achieve nearly 95% treatment efficacy across most patient groups.
- Effective treatment is now possible for previously difficult-to-treat populations, including HCV genotype 1 and advanced liver disease.
- IFN elimination enables safe treatment for patients with decompensated cirrhosis and transplant recipients.
Conclusions:
- DAA have revolutionized hepatitis C treatment, offering a potential cure for all patients.
- The development of potent and safe antiviral drugs, coupled with improved global access, could lead to HCV elimination.