Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Aug 18, 2015; 7(17): 2100-2109
Published online Aug 18, 2015. doi: 10.4254/wjh.v7.i17.2100
New treatment strategies for hepatitis C infection
Fatih Ermis, Elif Senocak Tasci
Fatih Ermis, Department of Gastroenterology, Duzce University Faculty of Medicine, 81620 Duzce, Turkey
Elif Senocak Tasci, Department of Internal Medicine, Duzce University Faculty of Medicine, 81620 Duzce, Turkey
Author contributions: Ermis F and Senocak Tasci E contributed equally to this work, generated the tables and figures and wrote the manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Fatih Ermis, MD, Associate Professor, Department of Gastroenterology, Duzce University Faculty of Medicine, Beciyorukler Street, Konuralp, 81620 Duzce, Turkey.
Telephone: +90-533-4689404
Received: April 5, 2015
Peer-review started: April 7, 2015
First decision: May 18, 2015
Revised: June 4, 2015
Accepted: July 18, 2015
Article in press: July 22, 2015
Published online: August 18, 2015

Hepatitis C infection can lead to cirrhosis and hepatocellular carcinoma and it is an important cause of mortality and morbidity. Achieving a sustained virological response has been the major aim for decades. Interferon treatment was the primarily developed therapy against the infection. Addition of the guanosine analog ribavirin to stop viral RNA synthesis increased the response rates as well as the adverse effects of the treatment. The increasing demands for alternative regimens led to the development of direct-acting antivirals (DAAs). The approval of sofosbuvir and simeprevir signaled a new era of antiviral treatment for hepatitis C infection. Although the majority of studies have been performed with DAAs in combination with interferon and resulted in a decrease in treatment duration and increase in response rates, the response rates achieved with interferon-free regimens provided hope for patients ineligible for therapy with interferon. Most DAA studies are in phase II leading to phase III. In the near future more DAAs are expected to be approved. The main disadvantage of the therapy remains the cost of the drugs. Here, we focus on new treatment strategies for hepatitis C infection as well as agents targeting hepatitis C virus replication that are in clinical development.

Keywords: Direct-acting antivirals, Eradication, Genotype, Hepatitis C virus infection, Interferon-free, Treatment

Core tip: In this review, we focused on different treatment regimens for hepatitis C infection, especially those including the newly developed and approved direct-acting antivirals. The guidelines are constantly changing in light of new studies. The recommendations of the guidelines are reviewed and consider different genotypes of the virus in addition to the results of ongoing studies. Continuing medical need for agents that act on novel hepatitis C virus targets has resulted in new compounds targeting viral proteins, which is also highlighted in the manuscript.