How has the treatment of chronic hepatitis C (hep C) infection evolved?

Updated: Oct 07, 2019
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: BS Anand, MD  more...
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Answer

The treatment of chronic hepatitis C has evolved rapidly. In the past the backbone of treatment for chronic hepatitis C virus (HCV) infection regardless of genotype was a combination therapy with injectable pegylated interferon-alfa (PEG-IFNa) plus oral ribavirin. Because it has the poorest safety profile of all the HCV antivirals, with few exceptions, PEG-IFN is no longer recommended in combination regimens. Ribavirin continues to be used in combination with sofosbuvir alone or other combinations.

The direct-acting antiviral agents (DAAs), first introduced in 2011, offered enhanced efficacy when combined with both PEG-IFN and ribavirin, particularly for genotype 1 infections. The first protease inhibitors, boceprevir and telaprevir, are no longer available for use in the United States and have been supplanted by antivirals with greater efficacy and improved safety profiles.


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