Optimal management of Hepatitis C genotype 2 chronic infection

Research output: Contribution to journalArticle

Abstract

Genotype 2 of the hepatitis C virus (HCV) accounts for 10 % of the patients with chronic HCV worldwide. Until 2013, the standard of care (SOC) and only therapeutic option in these patients was a course of 24 weeks of pegylated interferon (PegIFN) plus ribavirin (Rbv), with sustained virological response rates (SVRs) in the 80–90 % range. Despite the potentially high attainable SVR rates, PegIFN plus Rbv is poorly tolerated due to the side effects of both drugs and is often contraindicated due to concomitant comorbid conditions. The improved knowledge of the structure of the HCV genome and its life cycle has allowed to develop drugs that target key viral replication steps with the aim of directly inhibiting HCV replication. Among these so-called directly acting antivirals (DAAs), sofosbuvir (SOF), an NS5B HCV polymerase nucleotide analog inhibitor, has pan-genotypic activity and has been approved for the treatment of HCV genotypes 1, 2, 3, 4, 5, and 6 (HCV-1, HCV-2, HCV-3, HCV-4, HCV-5, and HCV-6) patients in combination with Rbv±PegIFN. For HCV-2, the combination of SOF plus Rbv represents the first all-oral IFN-free regimen that has become the new standard of care treatment. Phase III trials have reported optimal safety and high efficacy of SOF plus Rbv in patients with chronic HCV infection, with SVR rates for HCV-2 that reached 98–100 % by subgroup analysis. In countries where SOF is not available, treatment optimization of PegIFN/Rbv therapy is essential to maximize efficacy and reduce treatment-related side effects in HCV-2 patients.

Original languageEnglish
Pages (from-to)273-278
Number of pages6
JournalCurrent Hepatitis Reports
Volume13
Issue number4
DOIs
Publication statusPublished - Oct 3 2014

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Keywords

  • Cirrhosis
  • Directly acting antivirals
  • HCV-2
  • Hepatitis C
  • RVR
  • Short duration treatment
  • Sofosbuvir
  • SVR

ASJC Scopus subject areas

  • Hepatology
  • Virology

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