Clinical Pharmacokinetics

, Volume 53, Issue 5, pp 409–427 | Cite as

Viral Hepatitis C Therapy: Pharmacokinetic and Pharmacodynamic Considerations

  • Clara T. M. M. de Kanter
  • Joost P. H. Drenth
  • Joop E. Arends
  • Henk W. Reesink
  • Marc van der Valk
  • Robert J. de Knegt
  • David M. Burger
Review Article


Chronic hepatitis C is a global health problem. To prevent or reduce complications, the hepatitis C virus (HCV) infection needs to be eradicated. There have been several developments in treating these patients since the discovery of the virus. As of 1 January 2014, the drugs that are approved for treatment of chronic HCV infection are peginterferon-α, ribavirin, boceprevir, telaprevir, simeprevir and sofosbuvir. In this review we provide an overview of the clinical pharmacokinetic characteristics of these agents by describing their absorption, distribution, metabolism and excretion. In the pharmacodynamic part we summarize what is known about the relationships between the pharmacokinetics of each drug and efficacy or toxicity. We briefly discuss the pharmacokinetics and pharmacodynamics of chronic hepatitis C treatment in special patient populations, such as patients with liver cirrhosis, renal insufficiency or HCV/HIV coinfection, and children. With this knowledge, physicians, pharmacists, nurse practitioners, etc. should be educated to safely and effectively treat HCV-infected patients.



No sources of funding were used in the preparation of this review. Clara T. M. M. de Kanter and Joost P. H. Drenth have no conflicts of interest that are directly relevant to the content of this review. Joop E. Arends received consulting fees or payment for lectures from Janssen, BMS, Abbvie, Roche, MSD and Gilead. David M. Burger received research grants, consulting fees or payment for lectures from Merck, Janssen and Roche. Marc van der Valk received research grants or consulting fees from Janssen-Cilag, Abbvie, Gilead, BMS and MSD. Robert J. de Knegt received research grants, consulting fees or payment for lectures form Roche, BMS, Merck, Gilead, Abbvie and from Janssen-Cilag. Henk W. Reesink received research support or consulting fees from Abbvie, Astex, BMS, Boehringer Ingelheim, Gilead, GlaxoSmithCline, Janssen-Cilag, Merck, PRA-International, Roche, Santaris, Tibotec, R-Pharm and Regulus. However, these conflicts of interest did not influence the preparation of this review.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Clara T. M. M. de Kanter
    • 1
    • 2
  • Joost P. H. Drenth
    • 3
  • Joop E. Arends
    • 4
  • Henk W. Reesink
    • 5
  • Marc van der Valk
    • 6
  • Robert J. de Knegt
    • 7
  • David M. Burger
    • 1
    • 2
  1. 1.Department of Pharmacy864 Radboud university medical centerNijmegenThe Netherlands
  2. 2.Nijmegen Institute for Infection, Inflammation and Immunity (N4i)Radboud University Medical CenterNijmegenThe Netherlands
  3. 3.Department of GastroenterologyRadboud University Medical CenterNijmegenThe Netherlands
  4. 4.Department of Internal Medicine and Infectious DiseasesUniversity Medical CenterUtrechtThe Netherlands
  5. 5.Department of Gastroenterology and HepatologyAcademic Medical CenterAmsterdamThe Netherlands
  6. 6.Division of infectious DiseasesAcademic Medical CenterAmsterdamThe Netherlands
  7. 7.Department of Gastroenterology and HepatologyErasmus University Medical CenterRotterdamThe Netherlands

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