title: Optimal therapy in genotype 4 chronic hepatitis C: finally cured?
abstract: Optimal therapy for patients with hepatitis C virus (HCV) genotype 4 (HCV-4) infection is changing rapidly, and the possibility of a total cure is near. The standard of care has been combination pegylated interferon (PEG-IFN)-ribavirin (RBV), with modest response rates and considerable adverse events. Since the introduction of sofosbuvir (SOF), simeprevir (SIM), and daclatasvir (DCV), the duration of treatment has been significantly shortened and response rates have increased. The recommended treatment for IFN-eligible patients is PEG-IFN/RBV plus SOF, SIM or DCV. In IFN ineligible patients, the optimal regimen is a 24-week course of SOF/RBV, or a 12-week course of SOF-SIM or SOF-DCV with or without RBV. The pipeline for patients with chronic HCV is highly active. IFN-free combinations with paritaprevir-ombitasvir, SOF-ledipasvir, or DCV-asunaprevir (ASV)-beclabuvir (BMS-791325) for 12 weeks or less with close to 100% cure rates will soon become the optimal therapy.
authors.affiliation: Hepatology Department, National Liver Institute, Menoufiya University, Menoufiya, Egypt.
authors.forename: Wael
authors.initials: W
authors.lastname: Abdel-Razek
authors.forename: Imam
authors.initials: I
authors.lastname: Waked
mesh_terms: D002219:Carbamates; D004359:Drug Therapy, Combination / Q000379:methods / Q000639:trends*; D005838:Genotype; 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; D007093:Imidazoles / Q000627:therapeutic use*; D016898:Interferon-alpha / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011759:Pyrrolidines; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D000069616:Simeprevir; D000069474:Sofosbuvir; D013449:Sulfonamides / Q000627:therapeutic use*; D014542:Uridine Monophosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014633:Valine / Q000031:analogs & derivatives; D017361:Viral Nonstructural Proteins / Q000037:antagonists & inhibitors; D012324:RNA-Dependent RNA Polymerase
chemical_list: D002219:Carbamates; D006575:Heterocyclic Compounds, 3-Ring; D007093:Imidazoles; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D011759:Pyrrolidines; D011994:Recombinant Proteins; D012254:Ribavirin; D000069616:Simeprevir; D000069474:Sofosbuvir; D013449:Sulfonamides; D014542:Uridine Monophosphate; D014633:Valine; D017361:Viral Nonstructural Proteins; C087036:NS-5 protein, hepatitis C virus; D012324:RNA-Dependent RNA Polymerase; C549273:daclatasvir; C100416:peginterferon alfa-2a
keywords: direct acting antivirals; genotype 4; hepatitis C; interferon-free regimens