Pegylated interferon based therapy with second-wave direct-acting antivirals in genotype 1 chronic hepatitis C

• Published in: Liver international Vol. 35; no. s1; pp. 11 - 17
• Main Authors: Welch, Nicole M., Jensen, Donald M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.01.2015
• Subjects: Antiviral Agents - therapeutic use; direct-acting antiviral agents; Drug Therapy, Combination - methods; genotype 1 HCV; Hepacivirus - genetics; hepatitis C; hepatitis C therapy; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - genetics; Heterocyclic Compounds, 3-Ring - therapeutic use; Humans; Interferon-alpha - therapeutic use; pegylated interferon based therapies; Polyethylene Glycols - therapeutic use; Protease Inhibitors - therapeutic use; Recombinant Proteins - therapeutic use; Ribavirin - therapeutic use; Simeprevir; Sofosbuvir; Sulfonamides - therapeutic use; Uridine Monophosphate - analogs & derivatives; Uridine Monophosphate - therapeutic use; Viral Nonstructural Proteins - antagonists & inhibitors; hepatitis C therapy; direct-acting antiviral agents; hepatitis C; pegylated interferon based therapies; genotype 1 HCV
• ISSN: 1478-3223; 1478-3231
• DOI: 10.1111/liv.12715

Within the last few years, treatment of chronic hepatitis C infection has progressed beyond regimens containing the first‐wave direct‐acting antiviral agents (DAAs) boceprevir and telaprevir, which had high pill burdens as well as low efficacy and safety in treatment‐experienced patients. Triple therapy regimens with newer second‐wave DAAs combined with pegylated interferon (PEG‐IFN) and ribavirin (RBV), have shown rates of sustained virological response never before achieved with previous regimens in treatment‐naïve genotype 1 (HCV‐1) patients. Additionally, increased response rates have been found with quadruple agent therapy in prior non‐responders, partial‐responders, and relapsers, including those with cirrhosis. This review will focus on the second‐wave DAAs including protease inhibitors (PI), nucleotide inhibitors, and NS5B inhibitors combined with PEG‐IFN and RBV for both treatment‐naïve and treatment‐experienced genotype 1 hepatitis C virus (HCV‐1) infected patients. The current standard of care for treatment‐naïve HCV‐1 is the second‐wave PI, sofosbuvir, plus PEG‐IFN/RBV and sofosbuvir plus the second‐wave nucleotide inhibitor simeprevir with or without RBV in treatment‐experienced HCV‐1 patients. These recommendations could change, especially for treatment‐experienced patients based on the positive results obtained with the newest quadruple therapy studies.