Current Hepatitis Reports

, Volume 12, Issue 4, pp 246–250

Treatment of Chronic Hepatitis C, Genotype 4


    • Division of Gastroenterology and Hepatology, Department of Internal Medicine IIIMedical University of Vienna
Hepatitis C: Therapeutics (MP Manns and T von Hahn, Section editors)

DOI: 10.1007/s11901-013-0178-2

Cite this article as:
Ferenci, P. Curr Hepatitis Rep (2013) 12: 246. doi:10.1007/s11901-013-0178-2


HCV-genotype 4 is the predominant genotype in patients in North-East (especially in Egypt and Lybia) and Sub-Saharan Africa and in most Middle Eastern countries and is spread by migration and IVDU to Europe in the last years. Current treatment consists of peginterferon-alfa2 plus ribavirin (Peg/RBV) combination therapy using a response guided approach with sustained virologic response (SVR) rates about 60 %. Combination of Peg/RBV with drugs like nitazoxanide or silibinin appear to improve SVR rates, but they were not systematically studied. The first generation protease inhibitors have no activity in genotype 4 patients. In contrast, the second wave protease inhibitors (simeprevir, faldaprevir, r-danoprevir) and the NS5B NUC polymerase inhibitor Sofosbuvir are potent inhibitors of HCV replication, but have not been explored in phase 3 trials. Hopefully these drugs will become available for these patients.


Chronic hepatitis CGenotype 4Antiviral treatmentResponse guided therapy

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© Springer Science+Business Media New York 2013