[Chronic hepatitis C : Standard treatment and remaining challenges]

Area of Science:

• Hepatology
• Virology
• Pharmacology

Background:

• Chronic hepatitis C poses a risk of cirrhosis for 20-30% of patients within 30 years.
• Interferon-free antiviral therapy has revolutionized hepatitis C treatment, improving response rates, safety, and shortening treatment duration.

Purpose of the Study:

• To review the mechanism of action of current direct-acting antiviral drugs for hepatitis C.
• To outline current treatment recommendations for hepatitis C.

Main Methods:

• A selective literature search was conducted.
• The review focused on studies and reviews concerning the course and treatment of hepatitis C.

Main Results:

• Interferon-free regimens typically combine two direct-acting antivirals (e.g., RNA polymerase, protease, NS5A inhibitors) for 8-12 weeks.
• These treatments achieve sustained virologic response rates exceeding 95% and are safe and well-tolerated.
• Drug selection requires consideration of patient factors like hepatic/renal function and potential drug interactions.

Conclusions:

• Hepatitis C virus (HCV) can be eradicated in all patients, regardless of disease stage, using direct-acting antiviral combinations.
• HCV eradication leads to improved quality of life and reduced morbidity and mortality.