Interferon in the treatment of chronic hepatitis C: a drug caught between past and future.
BACKGROUND
Chronic hepatitis C affects 2.2 - 3% of the world population (130 million - 170 million). Pegylated IFN-α in combination with ribavirin, the currently approved therapy, leads to viral eradication in about 50% of treated patients, nevertheless it is associated with not negligible adverse events. Continuous efforts are being applied to improve the efficacy by means of new interferon molecules. Consensus IFN-α is currently available for use, while albumin-interferon, IFN-λ and IFN-ω are under investigation. Research is focussed on the directly acting antivirals, such as telaprevir and boceprevir, which are anticipated to enter the drug market during the next few years.


METHODS
This paper reviews the classification of interferons, mechanism of action, pegylated IFN-α molecules and their differences, current chronic hepatitis C treatment regimen and new drugs for HCV treatment.


CONCLUSIONS
Pegylated IFN-α will remain the basis of anti-HCV therapy during the next decade, since new IFN formulation are not proven to be superior or are in early stages of development and directly acting antivirals show limited antiviral activity as monotherapy.
A.M. Migliavacca Center for Liver Disease, First Division of Gastroenterology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli studi di Milano, Via F. Sforza 35, 20122 Milan, Italy. evezali@yahoo.com
Elena
E
Vezali
Alessio
A
Aghemo
Massimo
M
Colombo
D000818:Animals; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins; D018570:Risk Assessment; D016896:Treatment Outcome
D000998:Antiviral Agents; D015507:Drugs, Investigational; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D007372:Interferons; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a