Chronic Hepatitis C Treatment: Questions and Answers
Chronic Hepatitis C Treatment: Questions and Answers
Although the studies reviewed here differ in methodologies and assumptions about the efficacy of therapeutic modalities, their results are reasonably consistent with each other. In conclusion, using IFN/PEG-IFN or combination with RBV in the treatment of CHC patients with or without cirrhosis results in a long durable response, improved fibrosis and cirrhosis, decreased risk of liver decompensation, decreased mortality and morbidity rates, and increased survival and quality of life, especially in patients with SVR and in biochemical responders compared with nonresponders or untreated controls. On the other hand, the development of new and potent drugs for common resistance mutations and all HCV genotypes is under consideration. In these studies, IFN modifications, immune modulators, RNA interference, antisense oligonucleotides, cyclophilin inhibitors, host lipid biosynthesis inhibitors and natural products have been evaluated. Moreover, the development of new antivirals has focused on some particular areas such as RBV analogs, protease inhibitors, NS5B polymerase inhibitors, NS5A and helicase inhibitors. Finally, the US FDA approved telaprevir, a protease inhibitor, in May 2011, and new drugs are under development.
Expert Commentary & Five-year View
Although the studies reviewed here differ in methodologies and assumptions about the efficacy of therapeutic modalities, their results are reasonably consistent with each other. In conclusion, using IFN/PEG-IFN or combination with RBV in the treatment of CHC patients with or without cirrhosis results in a long durable response, improved fibrosis and cirrhosis, decreased risk of liver decompensation, decreased mortality and morbidity rates, and increased survival and quality of life, especially in patients with SVR and in biochemical responders compared with nonresponders or untreated controls. On the other hand, the development of new and potent drugs for common resistance mutations and all HCV genotypes is under consideration. In these studies, IFN modifications, immune modulators, RNA interference, antisense oligonucleotides, cyclophilin inhibitors, host lipid biosynthesis inhibitors and natural products have been evaluated. Moreover, the development of new antivirals has focused on some particular areas such as RBV analogs, protease inhibitors, NS5B polymerase inhibitors, NS5A and helicase inhibitors. Finally, the US FDA approved telaprevir, a protease inhibitor, in May 2011, and new drugs are under development.