S Zeuzem1. 1. Medizinische Klinik 1, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland. zeuzem@em.uni-frankfurt.de.
Abstract
BACKGROUND: Among patients with chronic hepatitis C, 20-30% develop cirrhosis and its complications within 30 years. The antiviral treatment of hepatitis C has become interferon-free, with resulting improvements in sustained virological response rates, safety and tolerability and a shorter duration of treatment. OBJECTIVE: The mechanism of action of available drugs and current treatment recommendations. MATERIAL AND METHODS: This review is based on relevant publications retrieved by a selective literature search and particularly on studies and reviews concerning the course and treatment of hepatitis C. RESULTS: The available drugs for interferon-free antiviral treatment of hepatitis C include inhibitors of the RNA-dependent RNA polymerase, NS3/4A protease, and NS5A protein of the hepatitis C virus (HCV), and ribavirin. Typically, two specific inhibitors are given in combination and the usual duration of treatment is 8-12 weeks. The antiviral drugs differ in their genotypic effectiveness and resistance barriers. The appropriate drug(s) should be chosen in consideration of the patient's hepatic and renal function and potential drug-drug interactions. All approved anti-HCV drugs are safe and well-tolerated and result in sustained virological response rates above 95%. CONCLUSION: All patients with hepatitis C, whatever their disease stage, can achieve a sustained eradication of HCV using a combination of drugs with direct antiviral activity. Viral eradication is associated with a better quality of life and with lower morbidity and mortality.
BACKGROUND: Among patients with chronic hepatitis C, 20-30% develop cirrhosis and its complications within 30 years. The antiviral treatment of hepatitis C has become interferon-free, with resulting improvements in sustained virological response rates, safety and tolerability and a shorter duration of treatment. OBJECTIVE: The mechanism of action of available drugs and current treatment recommendations. MATERIAL AND METHODS: This review is based on relevant publications retrieved by a selective literature search and particularly on studies and reviews concerning the course and treatment of hepatitis C. RESULTS: The available drugs for interferon-free antiviral treatment of hepatitis C include inhibitors of the RNA-dependent RNA polymerase, NS3/4A protease, and NS5A protein of the hepatitis C virus (HCV), and ribavirin. Typically, two specific inhibitors are given in combination and the usual duration of treatment is 8-12 weeks. The antiviral drugs differ in their genotypic effectiveness and resistance barriers. The appropriate drug(s) should be chosen in consideration of the patient's hepatic and renal function and potential drug-drug interactions. All approved anti-HCV drugs are safe and well-tolerated and result in sustained virological response rates above 95%. CONCLUSION: All patients with hepatitis C, whatever their disease stage, can achieve a sustained eradication of HCV using a combination of drugs with direct antiviral activity. Viral eradication is associated with a better quality of life and with lower morbidity and mortality.
Authors: Hélène Fontaine; Arnaud Lazarus; Stanislas Pol; Caroline Pecriaux; François Bagate; Philippe Sultanik; Estelle Boueyre; Marion Corouge; Vincent Mallet; Anaïs Vallet-Pichard; Philippe Sogni; Denis Duboc Journal: N Engl J Med Date: 2015-11-05 Impact factor: 91.245
Authors: Martin-Walter Welker; Stefan Luhne; Christian M Lange; Johannes Vermehren; Harald Farnik; Eva Herrmann; Tania Welzel; Stefan Zeuzem; Christoph Sarrazin Journal: J Hepatol Date: 2015-11-30 Impact factor: 25.083
Authors: Marcus M Mücke; Lisa I Backus; Victoria T Mücke; Nicola Coppola; Carmen M Preda; Ming-Lun Yeh; Lydia S Y Tang; Pamela S Belperio; Eleanor M Wilson; Ming-Lung Yu; Stefan Zeuzem; Eva Herrmann; Johannes Vermehren Journal: Lancet Gastroenterol Hepatol Date: 2018-01-19