title: The changing face of hepatitis C in the new era of direct-acting antivirals.
abstract: The approval of the first protease inhibitors as treatment for hepatitis C virus (HCV) infection is rapidly transforming the way patients with chronic hepatitis C are managed. Treatment regimens are moving to combinations given for shortened periods, excluding poorly tolerated subcutaneous interferon, and providing rates of cure exceeding 75%. The recognition of HCV infection as a systemic disease, not limited to producing liver damage, in which extrahepatic complications play a major role as the cause of morbidity and mortality, is prompting the treatment of a growing number of HCV-infected individuals. However, new challenges are emerging, including the need to diagnose a substantial proportion of asymptomatic carriers, the risk of potentially harmful drug-drug interactions and the high cost of medications. The future will probably see a progressive marginalization of residual HCV populations, with increasing over-representation of illegal immigrants, alcohol abusers, intravenous drug users and the mentally disabled.
authors.affiliation: Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain. vsoriano@dragonet.es
authors.forename: Vincent
authors.initials: V
authors.lastname: Soriano
authors.forename: Pablo
authors.initials: P
authors.lastname: Labarga
authors.forename: Jose V
authors.initials: JV
authors.lastname: Fernández-Montero
authors.forename: Jose M
authors.initials: JM
authors.lastname: Benito
authors.forename: Eva
authors.initials: E
authors.lastname: Poveda
authors.forename: Norma
authors.initials: N
authors.lastname: Rallon
authors.forename: Clara
authors.initials: C
authors.lastname: Sánchez
authors.forename: Eugenia
authors.initials: E
authors.lastname: Vispo
authors.forename: Pablo
authors.initials: P
authors.lastname: Barreiro
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000191:economics; D058070:Asymptomatic Diseases; D002353:Carrier State / Q000175:diagnosis / Q000188:drug therapy; D006297:Health Services Accessibility; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D009842:Oligopeptides / Q000008:administration & dosage* / Q000191:economics; D011392:Proline / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline