Therapy for Hepatitis C Genotype 3: Moving Forward

M. Buti; J. Llaneras; M. Riveiro-Barciela; R. Esteban


J Viral Hepat. 2015;22(9):683-690. 

In This Article

Abstract and Introduction


Until recently, the standard of care for hepatitis C virus genotype 3 infection was response-guided therapy with pegylated interferon plus ribavirin for 16 to 48 or 72 weeks. The introduction of sofosbuvir plus ribavirin has revolutionized hepatitis C virus therapy. Nowadays, the recommend treatment regimen is a combination of sofosbuvir and a weight-based ribavirin dose for 24 weeks. For easy to treat patients (e.g. naïve or previously treated patients without cirrhosis), this combination achieves high sustained virologic response rates and is well tolerated. However, in treatment-experienced patients with cirrhosis, sustained virologic response is lower due to unknown reasons. The combination of two direct-acting antiviral agents, sofosbuvir and daclatasvir, for 12 weeks is also associated with low sustained virologic response rates in this special population, for whom new drugs and different strategies are now under evaluation. Currently, the high cost of all these drugs limits access to treatment in many countries.


Several drugs are currently approved for the treatment of chronic hepatitis C genotype 3 (GT3) infection: pegylated interferon alfa 2a or 2b (PegIFN), ribavirin (RBV) and three direct-acting antiviral (DAA) agents, sofosbuvir (SOF), an NS5B polymerase inhibitor; daclatasvir (DCV), an NS5A protease inhibitor; and the combination of SOF plus ledipasvir (LDV), an NS5A protease inhibitor.[1–6] Two therapeutic strategies have been developed using these drugs: (i) interferon-based regimens including PegIFN plus RBV or PegIFN plus SOF and RBV, and (ii) interferon-free regimens, consisting of SOF plus RBV, SOF plus DCV with or without RBV, and SOF plus LDV. Each of these combinations has advantages and disadvantages, as well as differing safety profiles and costs. This article reviews the available therapy and the new treatment agents under development for patients with chronic hepatitis C GT3 infection.