TITLE:
A New Era in the Management of the Hepatitis C
AUTHORS:
Alfredo Arredondo Bruce, Osmani Risco Morales
KEYWORDS:
Hepatitis C, Sustained Virologic Response, Intolerable Side Effects or Adverse Events, Sofosbuvir and Simeprevir
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.12,
June
20,
2014
ABSTRACT: Hepatitis C is an infection
caused by the hepatitis C virus that attacks the liver and leads to inflammation.
The current standard-of-care regimens include a protease inhibitor—telaprevir
or boceprevir—in
combination with pegylated interferon and ribavirin. HepatitisC treatment options on the horizon hold promise for better viral clearance
with less toxicity than current regimens. There are new data about new drugs,
both direct-acting antivirals while minimizing intolerable side effects or adverse
events. Developed new data from 4 phase 3 trials with the hepatitis C drug sofosbuvir
and ribavirin show that a 12-week regimen is effective in treating HCV genotypes
1 through 6. In the Annual Scientific Meeting and Postgraduate Course of the American
College of Gastroenterology, different research was presented that was drawn from
4 phase 3 studies: NEUTRINO, FISSION, POSITRON and FUSION which enrolled different
types of patients, who received Sofosbuvir with Peginterferon Alfa 2a and Ribavirin
for 12 or 24 weeks in treatment; for all studies, the primary end point was sustained
virologic response at 12 and 24 weeks posttreatment. In all studies, sofosbuvir
was well tolerated, with a low incidence of adverse events. In conjunction with
the suggested brief duration of this regimen, this indicates that drug combinations
should improve treatment adherence compared with IFN-based treatment. In conclusion,
2 novel direct-acting antiviral agents—sofosbuvir
and simeprevir—target
various components of the HCV genome. Advantages of these drugs include a high
barrier to viral resistance, a shorter duration of treatment, once-daily dosing,
absence of food restrictions, few clinically significant drug interactions, and
similar efficacy in all genotypes.