New Hepatitis C Treatments (cont.)

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The first of the new, direct acting antiviral drugs - telaprevir (Incivek) and boceprevir (Victrelis) - still are used in combination with interferon and ribavirin. The exciting news is that drugs even newer than telaprevir and boceprevir are being approved for use that eliminate the need for interferon and, in some cases, ribavirin. Ultimately, they likely will be used as combinations of two or even three direct acting drugs without interferon or ribavirin. This eliminates the side effects of interferon and ribavirin. In addition, by using several drugs that act by blocking different parts of the hepatitis C virus genetic material or the liver cells' machinery, the combinations become more effective, and the development of resistance to any one drug is reduced. Approved drugs of the new class of direct acting antivirals include simeprevir (Olysio) and sofosbuvir (Sovaldi).

There is a lot more to learn about the new drugs. One thing that seems clear, however, is that they will be effective at eradicating hepatitis C virus (as previously mentioned, upwards of 85% effective). We still will need to learn what combinations are best and for how long it is necessary to treat patients. We also will need to learn more about the drugs' side effects, which will happen once they are used in larger numbers of patients. Nevertheless, this is an exciting time for the treatment of chronic infection with hepatitis C virus.

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Soriano V, Gane EJ, Angus PW, et al. Efficacy and safety of the interferon (IFN)-free combination of BI 201335 + B1 207127 +/- ribavirin (RBV) in treatment-naive patients with HCV genotype (GT) 1 infection and compensated liver cirrhosis: Results from the SOUND-C2 study. Hepatology. 2013;56:234A.

Jordan JF, Jacobson IM, Jensen DM, et al. Up to 100% SVR4 rates with ritonavir-boosted danoprevir (DNVr), mericitabine (MCB) and ribavirin (R) +/- peginterferon alfa-2a (40KD) (P) in HCV genotype 1-infected partial and null responders: results from the MATTERHORN study. Hepatology. 2013;56:231A.

Last Editorial Review: 6/12/2014