, Volume 10, Issue 3, pp 214-227
Date: 02 Jul 2011

Hepatitis C Viral Kinetics in the Era of Direct Acting Antiviral Agents and Interleukin-28B

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Abstract

In the last decade, hepatitis C virus (HCV) kinetics has become an important clinical tool for the optimization of therapy with pegylated-interferon-α (PEG-IFN) and ribavirin (RBV). Mathematical models have generated important insights into HCV pathogenesis, HCV-host dynamics, as well as IFN and RBV modes of action. Clinical trials with direct-acting antiviral agents (DAAs) against various steps of the HCV-life cycle have revealed new viral-kinetic patterns that have not been observed with (PEG)-IFN+RBV. Very recently, studies have shown that single nucleotide polymorphisms (SNPs) in the interleukin-28B (IL28B) gene region were associated with race/ethnicity, and with response to PEG-IFN+RBV. Here, we review our current knowledge of HCV kinetics and related mathematical models during (PEG)-IFN+RBV and/or DAA-based therapies, HCV pathogenesis, and the role of IL28B polymorphism on early HCV kinetics. Better understanding of the mode of actions of drugs and viral kinetics may help to develop new, individualized therapeutic regimens that include DAAs in combination with PEG-IFN+RBV.