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Update on Current Evidence for Hepatitis C Therapeutic Options in HCV Mono-infected Patients

Authors
  • Hull, Mark W.1, 2
  • Yoshida, Eric M.1
  • Montaner, Julio S. G.1, 2
  • 1 University of British Columbia, Division of AIDS, Faculty of Medicine, Room 667 1081 Burrard St, Vancouver, V6Z 1Y6, Canada , Vancouver (Canada)
  • 2 BC Centre for Excellence in HIV/AIDS, Vancouver, Canada , Vancouver (Canada)
Type
Published Article
Journal
Current Infectious Disease Reports
Publisher
Springer US
Publication Date
Jun 29, 2016
Volume
18
Issue
7
Identifiers
DOI: 10.1007/s11908-016-0527-8
Source
Springer Nature
Keywords
License
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Abstract

Purpose of ReviewTherapies for hepatitis C (HCV) are evolving rapidly with the advent of novel direct-acting antiviral agents (DAAs). We review evidence for currently or imminently available regimens to aide clinicians in understanding current therapeutic options.Recent FindingsA number of DAA combinations have completed clinical trials and are available for use. Current combinations are often genotype-specific, and combine HCV protease inhibitors, NS5A inhibitors and/or NS5B inhibitors to suppress HCV replication, leading to eradication. Current potential combinations for genotype 1 infection include sofosbuvir-ledipasvir, paritaprevir/ritonavir-ombitasvir-dasabuvir, sofosbuvir with daclatasvir, and grazoprevir-elbasvir. These regimens have been associated with sustained virologic response (SVR) rates of over 95 % for treatment naïve individuals after 12 weeks of therapy regardless of cirrhosis, and some sub-groups of patients may be successfully treated with just 8 weeks of sofosbuvir-ledipasvir. Regimens for genotype 2 and 3 include sofosbuvir with ribavirin, sofosbuvir with daclatasvir, or with velpatasvir, which may offer highest SVR rates when available. The development of HCV drug resistance, particularly against NS5A agents, may impact subsequent regimens. The need for baseline screening for resistant variants is unclear for most regimens, but likely would affect only a minority of patients.SummaryAll-oral curative regimens for HCV are now possible for most patients.

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