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Treatment of Chronic Hepatitis C: Current and Future

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Hepatitis C Virus: From Molecular Virology to Antiviral Therapy

Part of the book series: Current Topics in Microbiology and Immunology ((CT MICROBIOLOGY,volume 369))

Abstract

Resolution of the three-dimensional structures of several Hepatitis C virus (HCV) proteins, together with the development of replicative cell culture systems, has led to the identification of a number of potential targets for direct-acting antiviral agents (DAA). Numerous families of drugs that potently inhibit the HCV life cycle in vitro have been identified, and some of these molecules have reached early to late clinical development. Two NS3-4A protease inhibitors, telaprevir and boceprevir, were approved in Europe and the United States in 2011 in combination with pegylated interferon (IFN)-α and ribavirin for the treatment of chronic hepatitis C related to HCV genotype 1. A number of other DAAs are at the clinical developmental stage in combination with pegylated IFN-α and ribavirin or with other DAAs in IFN-free regimens, with or without ribavirin. They include second-wave, first-generation, and second-generation NS3-4A protease inhibitors, nucleoside/nucleotide analogue inhibitors, and non-nucleoside inhibitors of HCV RNA-dependent RNA polymerase, inhibitors of nonstructural protein 5A and host-targeted agents, such as cyclophilin A inhibitors and microRNA-122 antagonists. The proof of concept that IFN-free regimens can lead to HCV eradication has recently been brought. This chapter provides an overview of the current treatment of HCV infection and discusses the future of HCV therapy with new anti-HCV drugs.

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Conflicts of Interest

The author has received grant/research support from Gilead and Roche; he has served as an advisor for Abbott, Achillion, Anadys, Biotica, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead, Glaxo-SmithKline, Janssen, Merck, Novartis, Pfizer, and Roche.

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Authors and Affiliations

  1. National Reference Center for Viral Hepatitis B, C and Delta, Department of Virology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France

    Jean-Michel Pawlotsky

  2. INSERM U955, Créteil, France

    Jean-Michel Pawlotsky

  3. Department of Virology, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France

    Jean-Michel Pawlotsky

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  1. Jean-Michel Pawlotsky
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Correspondence to Jean-Michel Pawlotsky .

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Editors and Affiliations

  1. Department for Infectious Diseases Molecular Virology, University of Heidelberg, Heidelberg, Germany

    Ralf Bartenschlager

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Pawlotsky, JM. (2013). Treatment of Chronic Hepatitis C: Current and Future. In: Bartenschlager, R. (eds) Hepatitis C Virus: From Molecular Virology to Antiviral Therapy. Current Topics in Microbiology and Immunology, vol 369. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27340-7_13

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