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World J Hepatol. Jan 18, 2016; 8(2): 123-130
Published online Jan 18, 2016. doi: 10.4254/wjh.v8.i2.123
Ribavirin: Past, present and future
Véronique Loustaud-Ratti, Marilyne Debette-Gratien, Jérémie Jacques, Sophie Alain, Pierre Marquet, Denis Sautereau, Annick Rousseau, Paul Carrier
Véronique Loustaud-Ratti, Marilyne Debette-Gratien, Jérémie Jacques, Denis Sautereau, Paul Carrier, Fédération Hépatologie, Service d’Hépato-gastroentérologie, CHU Limoges, 87042 Limoges, France
Véronique Loustaud-Ratti, Marilyne Debette-Gratien, Pierre Marquet, Annick Rousseau, Paul Carrier, Université de Limoges, UMR 850 INSERM, 87025 Limoges, France
Sophie Alain, Service de Bactériologie Virologie, CHU Limoges, 87042 Limoges, France
Sophie Alain, U1092 INSERM, Université de Limoges, CHU Limoges, 87042 Limoges, France
Pierre Marquet, Service de Pharmacologie, CHU Limoges, 87042 Limoges, France
Author contributions: Loustaud-Ratti V and Carrier P wrote the manuscript; Debette-Gratien M, Jacques J, Alain S, Marquet P, Sautereau D and Rousseau A read the manuscript and conducted a critical analysis.
Conflict-of-interest statement: The authors have no conflict of interest concerning this work.
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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Véronique Loustaud-Ratti, Professor, Fédération Hépatologie, Service d’Hépato-gastroentérologie, CHU Limoges, 2 Avenue Martin Luther King, 87042 Limoges, France. veronique.loustaud-ratti@unilim.fr
Telephone: +33-5-55058484 Fax: +33-5-55056767
Received: September 2, 2015
Peer-review started: September 5, 2015
First decision: October 16, 2015
Revised: November 6, 2015
Accepted: December 29, 2015
Article in press: January 4, 2016
Published online: January 18, 2016
Processing time: 135 Days and 10.6 Hours
Core Tip

Core tip: Ribavirin plays a crucial role when associated with peginterferon, preventing relapses and breakthroughs and doubling the support vector regression rate. Its antiviral effect is weak and ribavirin could enhance the response of interferon-stimulated genes in the combination. Ribavirin is still useful in the era of approved new direct acting antiviral agents (DAAs), in order to shorter treatment duration in genotype 1 or 4 cirrhotic patients, in all options available for genotype 3 cirrhotic patients, and as the only drug associated with sofosbuvir in genotype 2. Preliminary data with interferon-free second generation DAAs combinations without ribavirin suggest that future of the drug is jeopardized.