The current state and future prospects of chronic hepatitis C virus infection treatment

Hepatitis C virus (HCV) infection is a significant cause of chronic liver disease with substantial long-term sequelae. Until very recently, therapies to cure HCV were hindered by high nonresponse rates and severe side effects. The first-generation protease inhibitor-containing regimens provided superior cure rates for many HCV-infected patients, although their side-effect profile proved to be quite burdensome. We are now witnessing the emergence of therapies with superior cure rates, limited side effects, and broad genotypic activity. Two therapies, sofosbuvir (an NS5b polymerase inhibitor) and simeprevir (a second-generation NS3/4A protease inhibitor), were approved by the Food and Drug Administration in late 2013 for use in a number of HCV populations. This review focuses primarily upon these therapies and the key studies that support their use in practice. Furthermore, representative novel antiviral therapies, in advanced stages of testing, are also reviewed.