期刊
GASTROENTEROLOGY
卷 146, 期 5, 页码 1176-1192出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/j.gastro.2014.03.003
关键词
Direct-Acting Antivirals; Interferon-Free Regimens; Sofosbuvir; Simeprevir; Daclatasvir
资金
- National Agency for Research on AIDS and Viral Hepatitis (ANRS)
- Fondation pour la Recherche Medicale (FRM)
- Institut National de la Sante et de la Recherche Medicale (INSERM)
- Universite Paris-Est (UPEC)
Therapy for hepatitis C is undergoing a revolution. Several new drugs against the hepatitis C virus (HCV) have reached the market and many others, including direct-acting antivirals and host-targeted agents, are in phase II or III clinical development. All-oral, interferon-free combinations of drugs are expected to cure more than 90% of infections. A vast amount of data from clinical trials are presented regularly at international conferences or released to the press before peer-review, creating confusion in the viral hepatitis field. The goal of this review is to clarify the current stage of HCV therapy and drug development. This review describes the different classes of drugs and their mechanisms and properties, as well as treatment strategies in development, including those that are interferon-based and interferon-free. HCV treatment options that will be available in 2014-2015 are presented for each genotype. A number of unanswered questions and challenges remain, such as how to treat special populations, the role of ribavirin in interferon-free regimens, the role of HCV resistance in treatment failures, and how to best re-treat patients who failed on treatment. Strategic choices, cost issues, HCV screening, and improving access to care in resource-constrained areas also are discussed.
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