title: Emerging therapeutic options in hepatitis C virus infection.
abstract: The current standard of care for patients with chronic hepatitis C virus (HCV) infection is pegylated interferon alfa in combination with ribavirin. Treatment duration and efficacy depend heavily on HCV genotype. A sustained virologic response (SVR) is achieved only in approximately 40% of patients. Side effects of the current standard of care often make adherence to therapy difficult, further reducing the chance for an SVR. Numerous patient-related and virus-related factors can determine response to treatment. Nonresponders are a large proportion of the current HCV-infected population, and the number of patients with HCV infection is growing, necessitating newer therapies with higher efficacy and potentially fewer side effects. A new era of direct acting antiviral (DAA) compounds has emerged. The first 2 protease inhibitors for HCV infection, telaprevir and boceprevir, are coming to market in 2011. Other protease compounds in development include TMC-435, vaniprevir, BI-201335, BMS-650032, and danoprevir. The numerous other therapies that have potential in the treatment of HCV infection include nucleoside inhibitors, non-nucleoside inhibitors, NS5A inhibitors, DAA combinations, therapeutic vaccines, human monoclonal antibodies, immune modifiers, and interferon lambda.
authors.affiliation: Department of Medicine, Cedars-Sinai Medical Center, 8635 W Third St, Ste 1060, Los Angeles, CA 90048, USA. fred.poordad@cshs.org
authors.forename: Fred
authors.initials: F
authors.lastname: Poordad
authors.forename: Vandana
authors.initials: V
authors.lastname: Khungar
mesh_terms: D000621:Aminoisobutyric Acids; D003521:Cyclopropanes; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D054833:Isoindoles; D007769:Lactams / Q000627:therapeutic use; D047029:Lactams, Macrocyclic; D007930:Leucine / Q000031:analogs & derivatives; D009842:Oligopeptides / Q000627:therapeutic use; D011392:Proline / Q000031:analogs & derivatives; D011804:Quinolines; D000069616:Simeprevir; D013449:Sulfonamides / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000621:Aminoisobutyric Acids; D003521:Cyclopropanes; D006575:Heterocyclic Compounds, 3-Ring; D007211:Indoles; D054833:Isoindoles; D007769:Lactams; D047029:Lactams, Macrocyclic; D009842:Oligopeptides; D011804:Quinolines; D013449:Sulfonamides; D013844:Thiazoles; C553752:danoprevir; C552340:faldaprevir; D011392:Proline; D000069616:Simeprevir; C540393:vaniprevir; D007930:Leucine