COMMENTARY

Hepatitis C: The Pace of Progress

Digestive Disease Week (DDW) 2013

William F. Balistreri, MD

Disclosures

June 06, 2013

In This Article

Interferon-Free Treatment: Still Searching

There is a high degree of optimism, however. Important observations presented this week may usher in the next generation of interferon-free treatment of HCV infection. Investigators have documented that several treatment protocols, which did not include interferon, were indeed capable of inducing high SVR rates in patients with chronic HCV.

In one study,[8] 3 direct-acting antiviral agents were administered in combination with ribavirin. These were ABT-450 (a potent NS3 protease inhibitor), ABT-330 (a nonnucleoside NS5B polymerase inhibitor), and ABT-267 (an NS5A inhibitor). The treatment regimen achieved high SVR rates in noncirrhotic treatment-naive patients and previous nonresponders, and the drugs were well tolerated. This preliminary study indicated that 12 weeks of therapy with this combination of 3 direct-acting antivirals and ribavirin may be effective for the treatment of HCV genotype 1 infection.

Other potential combinations of direct-acting antivirals were also discussed. In recently published studies,[9] sofosbuvir combined with ribavirin alone was shown to be effective for hepatitis C genotype 2 and 3 and possibly genotype 1. This regimen offers a low incidence of side effects, a relatively short duration of treatment, and was effective against all genotypes. These advantages may lower the threshold for HCV treatment for both patients and physicians.

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