title: Grazoprevir + elbasvir for the treatment of hepatitis C virus infection.
abstract: BACKGROUND
  Hepatitis C virus (HCV)-related liver disease is a cause of significant morbidity and mortality worldwide. Currently, direct-acting antiviral drugs (DAAs) are associated with an increased sustained virologic response (SVR) and are the gold standard for treating HCV infection.
  
  
  METHODS
  The new combination of grazoprevir, an inhibitor of HCV NS3/4A, and elbasvir, an inhibitor of HCV NS5A, once daily will be available for the treatment of HCV infection. This combination therapy has a high efficacy in HCV genotype 1 and 4 infections, inducing a SVR up to 95%, even in difficult to treat patients such as cirrhotic, HIV co-infected, or dialysis-dependent patients, and patients with stage 4-5 chronic kidney disease or those who failed previous therapy. The safety of grazoprevir combined with elbasvir is very good and without significant adverse effects in phase 2 or 3 studies. For patients who failed prior DAA therapy, in vitro and in vivo studies showed that the grazoprevir and elbasvir combination is fully active against resistance to NS3/4A protease inhibitors. Resistance to NS5B inhibitors is least susceptible to grazoprevir or elbasvir.
  
  
  CONCLUSIONS
  This new combination of gazoprevir with elbasvir offers an opportunity to cure HCV infection with short interferon-free therapy, even in difficult to treat patients.
authors.affiliation: a Department of Internal Medicine and Digestive Diseases , CHU Purpan Toulouse , France.|b UMR 152 , IRD Toulouse 3 University , France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.affiliation: a Department of Internal Medicine and Digestive Diseases , CHU Purpan Toulouse , France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Bonnet
mesh_terms: D000577:Amides; D000998:Antiviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001572:Benzofurans / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002219:Carbamates; D060085:Coinfection; D003521:Cyclopropanes; D004338:Drug Combinations; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007093:Imidazoles / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011480:Protease Inhibitors / Q000627:therapeutic use; D011810:Quinoxalines / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy; D013449:Sulfonamides; D047029:Lactams, Macrocyclic
chemical_list: D000577:Amides; D000998:Antiviral Agents; D001572:Benzofurans; D002219:Carbamates; D003521:Cyclopropanes; D004338:Drug Combinations; D007093:Imidazoles; D011480:Protease Inhibitors; D011810:Quinoxalines; D013449:Sulfonamides; C578009:grazoprevir; D047029:Lactams, Macrocyclic; C000589335:elbasvir
keywords: Grazoprevir; HCV; direct-acting antiviral drugs; elabsvir