title: Update on the treatment of hepatitis C genotypes 2-6.
abstract: OBJECTIVE
  The hepatitis C virus remains a global health issue, and the established standard of care has consisted of pegylated interferon alpha in conjunction with ribavirin. However, this regimen is associated with significant side-effects and poor sustained virological responses. The aim of this review is to assess the effects of the direct-acting antivirals upon hepatitis C genotypes 2-6 from publications from the past 18 months.
  
  
  RESULTS
  The impact of direct-acting antivirals has already substantially improved treatments for genotypes 2-6, with the size of improvement much less marked for genotype 3. Although still responsive to these agents, genotype 3 has inherent resistance to treatments possibly owing to its effects on host metabolic pathways. These treatments have moved sustained virological responses to the threshold of 90%, with reduced side-effects and shortened courses of treatment and some options for interferon-free therapy. These newer medications are transforming clinical guidelines at a rapid rate, but this will have to be balanced with the impact it places on global health budgets.
  
  
  CONCLUSIONS
  Although direct-acting antivirals are transforming the treatment of all hepatitis C genotypes, ongoing studies will optimize treatment duration and provide interferon-free alternatives.
authors.affiliation: aDepartment of Gastroenterology, Ninewells Hospital and Medical School bMedical Research Institute, University of Dundee, Dundee, DD1 9SY, UK.
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Paterson
authors.forename: Michael H
authors.initials: MH
authors.lastname: Miller
authors.forename: John F
authors.initials: JF
authors.lastname: Dillon
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D005838:Genotype; D014943:Global Health; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012254:Ribavirin / Q000008:administration & dosage*; D000069474:Sofosbuvir; D014542:Uridine Monophosphate / Q000008:administration & dosage / Q000031:analogs & derivatives*; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D014542:Uridine Monophosphate; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a; D000069474:Sofosbuvir