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INTRODUCTION Hepatitis C virus (HCV) is currently the most important cause of cirrhosis and hepatocellular carcinoma in the Western World. Remarkably, HCV is probably the only chronic human viral infectious agent that can be completely eradicated. Indeed, the occurrence of a sustained virological response (SVR) is almost always equivalent to a cure of the infection. More importantly, SVR is a time tested surrogate marker unequivocally linked to an increase in overall survival rate and lower incidence of hepatic decompensation, hepatocellular carcinoma and need for a liver transplant. For the last ten years HCV treatment has remained virtually unchanged, based almost exclusively on the combination of pegylated interferon alpha (PEG-IFNα) plus ribavirin (RBV). On May 2011 a new era started in the treatment of chronic hepatitis C, with the FDA approval of telaprevir (TVR) and boceprevir (BOC). These protease inhibitors were the first direct-acting antivirals (DAAs) to be used in routine clinical practice to treat patients with chronic hepatitis C and are now considered the standard of care for HCV genotype 1. These DAAs increase SVR and are able to shorten therapy in a significant proportion of both treatment-naïve and treatment-experienced chronic HCV infected patients. However, the extended adverse event profile and pill burden hamper their widespread clinical use. Two new anti-HCV DAA agents, simeprevir and sofosbuvir, have just submitted their phase 3 data to the FDA and will most likely enter the HCV clinical arena in 2014, with the promise of less side effects, once daily intake and a high probability of shortening therapy.

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2014-03-01   |   259 visitas   |   Evalua este artículo 0 valoraciones

Vol. 12 Núm.6. Noviembre-Diciembre 2013 Pags. 854-859 Ann Hepatol 2013; 12(6)