Published online Jun 28, 2015. doi: 10.4254/wjh.v7.i12.1617
Peer-review started: August 29, 2014
First decision: November 14, 2014
Revised: December 16, 2014
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: June 28, 2015
Processing time: 304 Days and 22.2 Hours
Hepatitis C virus (HCV) infection may lead to significant liver injury, and viral, environmental, host, immunologic and genetic factors may contribute to the differences in the disease expression and treatment response. In the early 2000s, dual therapy using a combination of pegylated interferon plus ribavirin (PR) became the standard of care for HCV treatment. In this PR era, predictive factors of therapy response related to virus and host have been identified. In 2010/2011, therapeutic regimens for HCV genotype 1 patients were modified, and the addition of NS3/4a protease inhibitors (boceprevir or telaprevir) to dual therapy increased the effectiveness and chances of sustained virologic response (SVR). Nevertheless, the first-generation triple therapy is associated with many adverse events, some of which are serious and associated with death, particularly in cirrhotic patients. This led to the need to identify viral and host predictive factors that might influence the SVR rate to triple therapy and avoid unnecessary exposure to these drugs. Over the past four years, hepatitis C treatment has been rapidly changing with the development of new therapies and other developments. Currently, with the more recent generations of pangenotipic antiviral therapies, there have been higher sustained virologic rates, and prognostic factors may not have the same importance and strength as before. Nonetheless, some variables may still be consistent with the low rates of non-response with regimens that include sofosbuvir, daclatasvir and ledipasvir. In this manuscript, we review the predictive factors of therapy response across the different treatment regimens over the last decade including the new antiviral drugs.
Core tip: Treatment of chronic hepatitis C has been changing very rapidly in recent years. The chances of cure have increased with the new drugs. Predictive factors of sustained treatment response in the “age” of based-interferon therapy is becoming less important with the arrival of the direct acting antivirals, however, viral genotype, cirrhosis and viral kinetics may still impact on therapy outcome with the new available drugs.