Cargando…

Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals

The development of protease inhibitors (PIs) such as telaprevir and boceprevir constitutes a milestone in chronic hepatitis C antiviral treatment since it has achieved sustained virological response (SVR) rates of up to 75% in naïve and 29-88% in treatment-experienced patients with genotype 1 infect...

Descripción completa

Detalles Bibliográficos
Autores principales: Alexopoulou, Alexandra, Karayiannis, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290005/
https://www.ncbi.nlm.nih.gov/pubmed/25608803
_version_ 1782352179165659136
author Alexopoulou, Alexandra
Karayiannis, Peter
author_facet Alexopoulou, Alexandra
Karayiannis, Peter
author_sort Alexopoulou, Alexandra
collection PubMed
description The development of protease inhibitors (PIs) such as telaprevir and boceprevir constitutes a milestone in chronic hepatitis C antiviral treatment since it has achieved sustained virological response (SVR) rates of up to 75% in naïve and 29-88% in treatment-experienced patients with genotype 1 infection. Both require combination treatment with pegylated interferon (PEG-IFN) plus ribavirin (RBV) as PI monotherapy results in resistant mutations. New direct acting antiviral agents (DAAs) have recently been approved or their approval is imminent. Simeprevir administered orally as one pill per day in combination with PEG-IFN/RBV will be the next PI to be approved. The SVR rates at about 72-80% for treatment-naïve patients are not a major improvement over telaprevir or boceprevir. However, this treble combination has fewer side effects and drug-drug interactions and most patients undergo shorter treatment duration (24 months) due to earlier treatment responses. Sofosbuvir is the first available once-daily NS5B polymerase inhibitor which has been approved in combination with PEG-IFN/RBV for just 12 weeks with 89% SVR in treatment-naïve patients with genotype 1 infection and 83-100% in treatment-experienced patients with genotypes 2/3. The current review focuses on the recent rapid and continuous developments in the management of chronic HCV infection with DAAs in combination with PEG-IFN/RBV.
format Online
Article
Text
id pubmed-4290005
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Hellenic Society of Gastroenterology
record_format MEDLINE/PubMed
spelling pubmed-42900052015-01-21 Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals Alexopoulou, Alexandra Karayiannis, Peter Ann Gastroenterol Review The development of protease inhibitors (PIs) such as telaprevir and boceprevir constitutes a milestone in chronic hepatitis C antiviral treatment since it has achieved sustained virological response (SVR) rates of up to 75% in naïve and 29-88% in treatment-experienced patients with genotype 1 infection. Both require combination treatment with pegylated interferon (PEG-IFN) plus ribavirin (RBV) as PI monotherapy results in resistant mutations. New direct acting antiviral agents (DAAs) have recently been approved or their approval is imminent. Simeprevir administered orally as one pill per day in combination with PEG-IFN/RBV will be the next PI to be approved. The SVR rates at about 72-80% for treatment-naïve patients are not a major improvement over telaprevir or boceprevir. However, this treble combination has fewer side effects and drug-drug interactions and most patients undergo shorter treatment duration (24 months) due to earlier treatment responses. Sofosbuvir is the first available once-daily NS5B polymerase inhibitor which has been approved in combination with PEG-IFN/RBV for just 12 weeks with 89% SVR in treatment-naïve patients with genotype 1 infection and 83-100% in treatment-experienced patients with genotypes 2/3. The current review focuses on the recent rapid and continuous developments in the management of chronic HCV infection with DAAs in combination with PEG-IFN/RBV. Hellenic Society of Gastroenterology 2015 /pmc/articles/PMC4290005/ /pubmed/25608803 Text en Copyright: © Hellenic Society of Gastroenterology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Alexopoulou, Alexandra
Karayiannis, Peter
Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals
title Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals
title_full Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals
title_fullStr Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals
title_full_unstemmed Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals
title_short Interferon-based combination treatment for chronic hepatitis C in the era of direct acting antivirals
title_sort interferon-based combination treatment for chronic hepatitis c in the era of direct acting antivirals
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290005/
https://www.ncbi.nlm.nih.gov/pubmed/25608803
work_keys_str_mv AT alexopouloualexandra interferonbasedcombinationtreatmentforchronichepatitiscintheeraofdirectactingantivirals
AT karayiannispeter interferonbasedcombinationtreatmentforchronichepatitiscintheeraofdirectactingantivirals