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Author Notes:

Correspondence: Lesley Miller Division of General Medicine, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303, USA Tel 1 404 778 1635 Fax 1 404 778 1601 Email lesley.miller@emory.edu

The authors report no conflicts of interest in this work.



  • hepatitis C
  • direct acting antivirals
  • genotype

Novel drugs in the management of difficult-to-treat hepatitis C genotypes


Journal Title:

Hepatic Medicine: Evidence and Research


Volume 5


, Pages 53-61

Type of Work:

Article | Final Publisher PDF


Background Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States, with approximately 3.2 million Americans being chronically infected. Rates of HCV-related end-stage liver disease and its associated morbidity and mortality have yet to peak, so there is a pressing need for more effective and tolerable HCV treatment. HCV genotypes 1, 4, 5, and 6 are considered difficult to treat, and the need for improved therapies is especially great for persons infected with these genotypes. Current strategies for HCV treatment Current therapy for genotype 1 HCV infection includes triple therapy with pegylated interferon, ribavirin, and a NS3/4A protease inhibitor. Sustained virologic response (SVR) rates with triple therapy range from 42% to 75%, a vast improvement over pegylated interferon and ribavirin therapy alone. However, response rates remain suboptimal, and triple therapy is associated with significant adverse effects and is only indicated for genotype 1 HCV infection. Novel drugs for HCV treatment HCV drug development is proceeding at a rapid pace to meet this need. Novel direct acting antiviral agents in several classes, including new NS3/4A serine protease inhibitors, NS5A replication complex inhibitors, NS5B polymerase inhibitors, interferon lambda, and microRNAs, are in varying stages of development. These new therapeutic agents promise SVR rates of up to 100% with durations as short as 12 weeks and, often, fewer adverse effects. Conclusion New drug development in HCV is proceeding at an unprecedented pace. Novel agents promise higher SVR rates, shorter duration of therapy, and fewer adverse effects than have been possible with HCV therapy to date.

Copyright information:

© 2013 Cartwright and Miller, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

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