Direct-acting antivirals for the treatment of hepatitis C virus infection: optimizing current IFN-free treatment and future perspectives

Liver Int. 2016 Jan:36 Suppl 1:47-57. doi: 10.1111/liv.13027.

Abstract

There has been a revolution in the treatment of chronic hepatitis C. Several oral regimens combining direct-acting antivirals (DAAs) from different families [NS5B nucleotide inhibitors, NS5B non-nucleoside inhibitors, NS5A replication complex inhibitors and NS3/4A protease inhibitors (PI)] have been developed. These regimens result in an increase in sustained virological response (SVR) rates to above 90% and reduce the duration of treatment to 12 weeks or less. As of 2016 several regimens will be approved with additive potencies, without cross-resistance and with a good safety profile. Remaining issues will include increasing screening and access to care so that HCV may become the first chronic viral infection eradicated worldwide. This review summarizes results obtained with oral DAA combinations that have been approved and/or have completed phase 3 clinical trials for HCV infection and discusses future perspectives.

Keywords: dasabuvir grazoprevir; elbasvir; ledipasvir; ombitasvir; paritaprevir; sofosbuvir; velpatasvir.

Publication types

  • Review

MeSH terms

  • 2-Naphthylamine
  • Amides
  • Anilides / therapeutic use
  • Antiviral Agents / therapeutic use*
  • Benzimidazoles / therapeutic use
  • Benzofurans / therapeutic use
  • Carbamates / therapeutic use
  • Cyclopropanes
  • Drug Therapy, Combination
  • Female
  • Fluorenes / therapeutic use
  • Genotype
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / drug therapy*
  • Heterocyclic Compounds, 4 or More Rings / therapeutic use
  • Humans
  • Imidazoles / therapeutic use
  • Lactams, Macrocyclic
  • Macrocyclic Compounds / therapeutic use
  • Proline / analogs & derivatives
  • Protease Inhibitors / therapeutic use*
  • Quinoxalines / therapeutic use
  • Sofosbuvir / therapeutic use
  • Sulfonamides / therapeutic use
  • Uracil / analogs & derivatives
  • Uracil / therapeutic use
  • Valine
  • Viral Nonstructural Proteins / antagonists & inhibitors*

Substances

  • Amides
  • Anilides
  • Antiviral Agents
  • Benzimidazoles
  • Benzofurans
  • Carbamates
  • Cyclopropanes
  • Fluorenes
  • Heterocyclic Compounds, 4 or More Rings
  • Imidazoles
  • Lactams, Macrocyclic
  • Macrocyclic Compounds
  • Protease Inhibitors
  • Quinoxalines
  • Sulfonamides
  • Viral Nonstructural Proteins
  • ledipasvir
  • ombitasvir
  • grazoprevir
  • Uracil
  • elbasvir
  • Proline
  • 2-Naphthylamine
  • dasabuvir
  • NS-5 protein, hepatitis C virus
  • Valine
  • velpatasvir
  • paritaprevir
  • Sofosbuvir