Trends in hepatitis C virus infection therapy: protease inhibitors a step forward in the era of direct acting antivirals.

The standard of care for the treatment of HCV infected patients was until 2011 the association peginterferon-ribavirin with a sustained virologic response of 50%. In 2011 another class of antivirals was approved by the FDA and EMEA--the HCV-NS3 protease inhibitors. Two molecules are now available: boceprevir and telaprevir. The protease inhibitors are used in association with peginterferon and ribavirin, which remain vital therapy components. Protease inhibitor regimens substantially increased the SVR rate in naive patients and also in previously relapse patients. Because of the high risk of emerging resistance to protease inhibitors, prior null responders are not yet suitable candidates for triple therapy, the SVR rate in these patients is still very low.