Treatment of hepatitis C with new fixed dose combinations

  title={Treatment of hepatitis C with new fixed dose combinations},
  author={Vincent Soriano and Jos{\'e} Vicente Fern{\'a}ndez-Montero and Carmen de Mendoza and Laura Ben{\'i}tez-Guti{\'e}rrez and Jos{\'e} Ma Pe{\~n}a and Ana Arias and Pablo Barreiro},
  journal={Expert Opinion on Pharmacotherapy},
  pages={1235 - 1242}
ABSTRACT Introduction: The advent of oral direct-acting antivirals (DAA) has revolutionized the hepatitis C virus (HCV) therapeutic landscape providing cure rates over 90%. However, a subset of patients remains at higher risk for treatment failure, including those infected with: i) genotype 3 and cirrhosis; ii) resistance-associated substitutions (RAS) occurring either as natural polymorphisms or selected after prior DAA failure; and iii) poor drug adherence associated with social disabilities… 
NS5B polymerase inhibitors in phase II clinical trials for HCV infection
This review outlines the main clinical data concerning novel NS5B polymerase inhibitors currently in pipeline, focusing on the ones that have completed a phase 2 trial.
Case Report and Review of Management of HIV/HCV Coinfection After Treatment Failure
A case of a patient who was treated multiple times using DAA therapy is described and the evolution of hepatitis C is discussed, with specific implications for management.
Is Ribavirin Teratogenic in Humans? No Evidence So Far
An interim analysis is made of the major findings collected at the Ribavirin Pregnancy Registry, a large database established in 2003 in USA in response to a Food and Drug Administration post-marketing request to collect information from pregnant women exposed to RBV.
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There is no doubt that the individual success of direct-acting antivirals is largely contributing to halt HCV transmission globally, in the absence of an effective HCV prophylactic vaccine.
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Overall, most adverse events (AEs) were mild‐to‐moderate in severity with serious AEs and AEs leading to G/P discontinuation occurring at similarly low rates in both patient populations.
Integrated analysis of 8-week glecaprevir/pibrentasvir in Japanese and overseas patients without cirrhosis and with hepatitis C virus genotype 1 or 2 infection
8-week G/P treatment is safe and efficacious in DAA-naive patients without cirrhosis and with HCV GT1 or GT2 infection, demonstrating high SVR12 rates regardless of baseline patient and disease characteristics.
Subtype-Specific Prevalence of Hepatitis C Virus NS5A Resistance Associated Substitutions in Mainland China
Subtype-specific distribution patterns of NS5A RASs were observed, indicating circulation of both locally and nationally epidemic strains and patients with higher HCV complexity tend to have a greater chance of Y93H presence, while GT3b patients are naturally resistant to currentNS5A inhibitors and their treatment may pose a challenge to real-world DAA application.
Retreatment Efficacy of Sofosbuvir/Ombitasvir/Paritaprevir/Ritonavir + Ribavirin for Hepatitis C Virus Genotype 4 Patients
The recent multi-targeted regimen of SOF plus OBV/PTV/r + RBV was well tolerated and achieved excellent SVR rates among retreatment-experienced Egyptian patients with prior DAA treatments failure, thus providing an alternative regimen for the retreatment of difficult-to-cure HCV GT4 patients.
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A panel of Italian experts was convened twice, in November 2016 and January 2017, to provide further support on some open issues and provide guidance for personalized HCV care, also in light of forthcoming regimens.
Prevention of liver cancer with new curative hepatitis C antivirals: Real‐world challenges
The advent of new HCV drugs known as direct-acting antivirals (DAAs), which provide unprecedented and very high curative rates with short courses (8-12 weeks) of oral therapy, has transformed chronic hepatitis C into a curable condition and form the basis for evaluating the impact of DAA therapy in the coming years.


Prevention and management of treatment failure to new oral hepatitis C drugs
The management of HCV treatment failure and the impact of RAVs on re-treatment strategies are discussed and it is unclear when and how to re-treat hepatitis C in patients with prior DAA failure.
Hepatitis C virus resistance to the new direct-acting antivirals
Although DAA failures generally occur in less than 10% of treated chronic hepatitis C patients, selection of drug resistance is the rule in most cases and first-line therapeutic strategies should be optimized to efficiently prevent DAA failure due to baseline HCV resistance.
Management of direct-acting antiviral agent failures.
Hepatitis C Virus-Genotype 3: Update on Current and Emergent Therapeutic Interventions
Current and emergent DAA regimens for HCV-GT3 treatment are discussed, and disruption of HCV entry by targeting required host cellular receptors shows potential in minimizing HCV resistance and broadening therapeutic options for certain subpopulations of GT3 patients.
Hepatitis C Virus Resistance to Direct-Acting Antiviral Drugs in Interferon-Free Regimens.
First-line treatment strategies should be optimized to efficiently prevent treatment failure due to HCV resistance, as viral variants resistant to NS5A inhibitors at baseline is associated with lower rates of virological cure in certain groups of patients.
Pharmacologic Considerations in the Treatment of Hepatitis C Virus in Persons With HIV.
  • C. MacBrayne, J. Kiser
  • Medicine, Biology
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2016
The clinical pharmacology and drug interaction potential of the DAAs, the interaction data with DAAs and antiretroviral agents, and the knowledge gaps in the pharmacologic aspects of treating HCV in individuals with HIV coinfection are described.
Efficacy of Sofosbuvir, Velpatasvir, and GS-9857 in Patients With Genotype 1 Hepatitis C Virus Infection in an Open-Label, Phase 2 Trial.
In a phase 2 open-label trial, 8 weeks of treatment with sofosbuvir-velpatasvir plus GS-9857 to be safe and effective in treatment-naive patients; 12 weeks was safe andeffective in patients previously treated with DAAs.
Glecaprevir and pibrentasvir for 12 weeks for hepatitis C virus genotype 1 infection and prior direct‐acting antiviral treatment
The combination of GLE and PIB was highly efficacious and well tolerated in patients with HCV genotype 1 infection and prior failure of DAA‐containing therapy; RBV coadministration did not improve efficacy.