title: Recent advances and future directions in the management of hepatitis C infections.
abstract: Current estimates indicate that the hepatitis C virus is the leading cause of death in the United States with infection rates steadily increasing. Successful treatment is made difficult by the presence of various host, virus, and treatment-related factors, warranting the development of new approaches to combat the silent epidemic. The addition of telaprevir and boceprevir to the pharmacotherapeutic arsenal drastically improved success rates in genotype 1 infected patients, but rapid development of resistance mechanisms, increases in adverse effects, and a low spectrum activity proved to be barriers to efficacious treatment. In late 2013, two new agents were approved - sofosbuvir and simeprevir - that have higher barriers to resistance, favorable safety profiles, and profoundly improved success rates; however higher costs associated with the new medications could limit their wider utilization. Further strategies to combat the virus are under development, ranging from interferon-free regimens as well as prophylactic and therapeutic vaccines to applications of nanotechnology, helping us get closer to improved treatment of patients infected with hepatitis C.
authors.affiliation: The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, One Discovery Drive, Rensselaer, NY 12144, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Belousova
authors.affiliation: The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, One Discovery Drive, Rensselaer, NY 12144, USA; Hormones Department, Medical Research Division, National Research Center, Cairo, Egypt; Center for Aging and Associated Diseases, Zewail City of Science and Technology, 6th of October, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Abd-Rabou
authors.affiliation: The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, One Discovery Drive, Rensselaer, NY 12144, USA. Electronic address: shaker.mousa@acphs.edu.
authors.forename: Shaker A
authors.initials: SA
authors.lastname: Mousa
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D016174:Hepacivirus / Q000187:drug effects; D006526:Hepatitis C / Q000188:drug therapy*; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use; D006801:Humans; D000069616:Simeprevir; D000069474:Sofosbuvir; D013449:Sulfonamides / Q000627:therapeutic use; D017211:Treatment Failure; D014542:Uridine Monophosphate / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D006575:Heterocyclic Compounds, 3-Ring; D013449:Sulfonamides; D000069616:Simeprevir; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: HCV genotypes; Hepatitis C prevention; Hepatitis C treatment; Hepatitis C virus; Interferon-free regimens; Vaccine