Hepatitis C: management of side effects in the era of direct-acting antivirals.

Triple therapy with either boceprevir (BOC) or telaprevir (TVR) in combination with pegylated interferon-alfa (PEG-IFN) and ribavirin (RBV) has given clinicians a more effective armamentarium and has established a new standard of care for the treatment of chronic hepatitis C (CHC). These advances have come with the caveat of continued adverse effects of dual therapy, with a new set of adverse effects related specifically to the protease inhibitors, BOC and TVR. Hematologic, dermatologic, and gastrointestinal adverse effects require careful monitoring and specific interventions, which will assist in completing therapy and achieving SVR. With appropriate clinical awareness and monitoring, treatment of CHC with triple therapy can be highly successful.