Newer direct-acting antivirals for hepatitis C virus infection: Perspectives for India

Varun Gupta1, Ashish Kumar1, Praveen Sharma1

  • 1Institute of Liver, Gastroenterology, & Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, India.

Insights

Direct-acting antivirals (DAAs) have revolutionized hepatitis C virus (HCV) treatment, offering high cure rates and better tolerability. Sofosbuvir-based strategies are key for managing HCV genotypes 3 and 1 in India, including cirrhosis.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Chronic hepatitis C virus (HCV) infection affects 170-200 million globally, causing significant mortality and healthcare costs, particularly in India.
  • HCV treatment evolved from interferon (IFN)-based therapies to pegylated-IFN (PEG-IFN) and ribavirin (RBV), with improved tolerability.
  • Direct-acting antivirals (DAAs) represent a revolutionary advancement in HCV treatment, targeting virus-specific proteins.

Purpose of the Study:

  • To review direct-acting antivirals (DAAs) for chronic hepatitis C virus (HCV) infection.
  • To discuss the role of sofosbuvir (SOF) in various HCV genotypes and liver disease stages.
  • To propose SOF-based treatment strategies for prevalent Indian HCV genotypes (3 and 1) and cirrhosis.

Main Methods:

  • Review of existing literature on direct-acting antivirals (DAAs) for hepatitis C virus (HCV).
  • Focus on sofosbuvir (SOF) efficacy, tolerability, and application in different HCV genotypes.
  • Development of treatment strategies incorporating SOF for genotype 3, genotype 1, and cirrhosis.

Main Results:

  • Direct-acting antivirals (DAAs) achieve high HCV cure rates with reduced treatment durations and excellent patient tolerability.
  • Sofosbuvir (SOF) is a highly effective DAA, crucial for HCV management in India due to its availability at a compassionate price.
  • SOF-based regimens are being adopted in India, particularly for prevalent genotypes 3 and 1, and in patients with cirrhosis.

Conclusions:

  • Direct-acting antivirals (DAAs), especially sofosbuvir (SOF), have transformed chronic hepatitis C virus (HCV) treatment globally and in India.
  • SOF-based management strategies offer a highly effective and well-tolerated option for HCV genotypes 3 and 1, including cirrhotic patients.
  • Further development of SOF-based treatment protocols is essential for optimizing HCV care in India.

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