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Is the 25-year hepatitis C marathon coming to an end to declare victory?
Khulood T Ahmed1, Ashraf A Almashhrawi1, Jamal A Ibdah1
1Khulood T Ahmed, Ashraf A Almashhrawi, Jamal A Ibdah, Veysel Tahan, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States.
Insights
Hepatitis C virus (HCV) treatments have evolved from interferon-based therapies with limited success and side effects to highly effective, tolerable oral direct-acting antiviral agents. Global access and prevention remain crucial for eradicating this infection.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection is a significant global health issue, affecting approximately 3% of the world's population.
- Historically, interferon/peginterferon and ribavirin combination therapy was the standard treatment for chronic HCV, achieving around 50% success rates but causing numerous side effects.
- Many patients, particularly those with comorbidities like psychiatric diseases or cytopenias, were excluded from interferon-based treatments.
Purpose of the Study:
- To highlight the transformative shift in Hepatitis C virus (HCV) treatment paradigms.
- To emphasize the advantages of new direct-acting antiviral (DAA) therapies over older interferon-based regimens.
- To underscore the ongoing need for global access, screening, and prevention strategies for HCV.
Main Methods:
- Review of historical and current therapeutic strategies for Hepatitis C virus (HCV).
- Analysis of treatment efficacy, tolerability, and patient eligibility criteria for interferon-based versus direct-acting antiviral (DAA) regimens.
- Discussion of global health considerations including access to medication and future eradication efforts.
Main Results:
- Direct-acting antiviral (DAA) agents have enabled interferon-free and ribavirin-free oral regimens for Hepatitis C virus (HCV).
- These new oral regimens demonstrate high rates of response and improved tolerability compared to previous treatments.
- Injectable medications are no longer required for HCV treatment.
Conclusions:
- The advent of direct-acting antivirals (DAAs) represents a major advancement in Hepatitis C virus (HCV) management, offering effective and well-tolerated oral treatment options.
- Ensuring equitable access to these life-saving medications globally is paramount, alongside continued efforts in disease prevention and screening.
- The development of an effective Hepatitis C virus (HCV) vaccine remains a critical goal for complete worldwide eradication.
Abstract:
Hepatitis C virus (HCV) which was originally recognized as posttransfusion non-A, non-B hepatitis has been a major global health problem affecting 3% of the world population. Interferon/peginterferon and ribavirin combination therapy was the backbone of chronic HCV therapy for two decades of the journey. However, the interferon based treatment success rate was around 50% with many side effects. Many chronic HCV patients with psychiatric diseases, or even cytopenias, were ineligible for HCV treatment. Now, we no longer need any injectable medicine. New direct-acting antiviral agents against HCV allowed the advance of interferon-free and ribavirin-free oral regimens with high rates of response and tolerability. The cost of the medications should not be a barrier to their access in certain parts of the world. While we are getting closer, we should still focus on preventing the spread of the disease, screening and delivering the cure globally to those in need. In the near future, development of an effective vaccine against HCV would make it possible to eradicate HCV infection worldwide completely.
