title: Desirable Characteristics of Hepatitis C Treatment Regimens: A Review of What We Have and What We Need.
abstract: There have been dramatic advancements in the treatment of chronic hepatitis C (HCV) infection. This is largely due to the approval of several direct-acting antiviral agents (DAAs) from a variety of medication classes with novel mechanisms of action. These therapies are a welcomed advancement given their improved efficacy and tolerability compared to pegylated interferon and ribavirin (RBV)-based regimens. These convenient, all-oral regimens treat a variety of genotypes and often offer high cure rates in a variety of HCV-infected populations. While there are several benefits associated with these therapies, there are also notable shortcomings. Shortcomings include diminished response or need for adjunctive RBV in difficult-to-treat populations (decompensated cirrhosis, active substance abuse patients, advanced kidney disease, etc.), activity against select genotypes, substantial drug-drug interaction potential, and high cost. Therefore, while current DAA-based therapies have several favorable attributes, each also has its limitations. The purpose of this review is to (1) identify the characteristics of an ideal HCV treatment regimen, (2) describe desirable features of existing regimens, (3) summarize limitations of existing regimens, and (4) introduce promising emerging therapies. This manuscript will serve as a guide for evaluating the caliber of future HCV treatment regimens.
authors.affiliation: Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY, 12208, USA.
authors.forename: Monique R
authors.initials: MR
authors.lastname: Bidell
authors.affiliation: Department of Pharmacy Practice, Midwestern University Chicago College of Pharmacy, 555 31st St, Downers Grove, Downers Grove, IL, 60515, USA.|Department of Pharmacy, Northwestern Memorial Hospital, 251 E Huron St, Chicago, IL, 60611, USA.
authors.forename: Milena
authors.initials: M
authors.lastname: McLaughlin
authors.affiliation: Division of HIV Medicine, Albany Medical College, 43 New Scotland Avenue, Albany, NY, 12208, USA.
authors.forename: John
authors.initials: J
authors.lastname: Faragon
authors.affiliation: Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY, 12208, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Morse
authors.affiliation: Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY, 12208, USA. Nimish.patel@acphs.edu.
authors.forename: Nimish
authors.identifier: http://orcid.org/0000-0003-0921-549X
authors.initials: N
authors.lastname: Patel
keywords: Effectiveness; Genotype; Hepatitis C; Pharmacotherapy; Response; Safety; Treatment