H Wedemeyer1. 1. Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30623, Hannover, Deutschland, wedemeyer.heiner@mh-hannover.de.
Abstract
BACKGROUND: Treatment of hepatitis C is changing dramatically. Various new direct-acting antivirals (DAA) against HCV have recently been approved or will become available during the next months. OBJECTIVES: To summarize the efficacy of DAAs and to describe optimal treatment regimens for chronic hepatitis C. METHODS: Review of selected phase 2 and 3 trials investigating anti-HCV drugs and recent HCV guidelines. RESULTS: New HCV therapies are interferon-free and lead to sustained HCV clearance in >90% of cases. DAAs include HCV protease inhibitors, NS5A inhibitors as well as nucleotide and non-nucleoside HCV polymerase inhibitors. Depending on the stage of liver disease, HCV genotype and viral load, treatment duration is 8-24 weeks. Ribavirin is not needed anymore in every case. Resistance against HCV drugs is not a major factor determining treatment response, but resistance testing is recommended in case of treatment failures before re-treatment is considered. CONCLUSIONS: Chronic hepatitis C is a curable disease. It remains to be determined to what extent HCV clearance will alter liver function and the risk for hepatocellular carcinoma in patients with liver cirrhosis.
BACKGROUND: Treatment of hepatitis C is changing dramatically. Various new direct-acting antivirals (DAA) against HCV have recently been approved or will become available during the next months. OBJECTIVES: To summarize the efficacy of DAAs and to describe optimal treatment regimens for chronic hepatitis C. METHODS: Review of selected phase 2 and 3 trials investigating anti-HCV drugs and recent HCV guidelines. RESULTS: New HCV therapies are interferon-free and lead to sustained HCV clearance in >90% of cases. DAAs include HCV protease inhibitors, NS5A inhibitors as well as nucleotide and non-nucleoside HCV polymerase inhibitors. Depending on the stage of liver disease, HCV genotype and viral load, treatment duration is 8-24 weeks. Ribavirin is not needed anymore in every case. Resistance against HCV drugs is not a major factor determining treatment response, but resistance testing is recommended in case of treatment failures before re-treatment is considered. CONCLUSIONS:Chronic hepatitis C is a curable disease. It remains to be determined to what extent HCV clearance will alter liver function and the risk for hepatocellular carcinoma in patients with liver cirrhosis.
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