Currently, the most widely prescribed standard therapy for chronic hepatitis C consists of pegylated-interferon combined with ribavirin. Although the response rate to interferon-based treatments has improved since interferon monotherapy was first combined with ribavirin, and then pegylated-interferon was adopted, patients eligible for this treatment are limited; the side effects are unbearable in some patients, and the response rates are still unsatisfactory for those who have unfavorable clinical features. Achievements in molecular research have led to the discovery of enormous molecules with anti-hepatitis C virus (HCV) activity. Telaprevir, boceprevir, simeprevir, and sofosbuvir have already been approved by the U.S. Food and Drug Administration and many new drugs are being evaluated in ongoing clinical trials. We review the clinical efficacy of approved new anti-HCV drugs, along with many promising treatment options under development.
Hepatitis C, Chronic* ; Humans ; Interferons ; Ribavirin ; United States Food and Drug Administration ; Simeprevir

No abstract available.
Antiviral Agents/*administration & dosage ; Female ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon-alpha/*administration & dosage ; Male ; Polyethylene Glycols/*administration & dosage ; Recombinant Proteins/administration & dosage ; Ribavirin/*administration & dosage

Aerosols ; Antiviral Agents ; administration & dosage ; Child ; Child, Preschool ; Female ; Herpangina ; drug therapy ; Humans ; Infant ; Male ; Ribavirin ; administration & dosage

Chronic infection with HCV represents second most common cause of end-stage liver diseases and hepatocellular carcinoma in Korea. The introduction of new agents and regimens for the treatment of chronic hepatitis C, such as pegylated forms of interferon-alpha (Peg-IFN) and combination with oral ribavirin has resulted in substantial improvement in sustained virologic response (SVR) rates. SVR rate of Peg-IFN and ribavirin combination therapy can be 40-46% of individuals infected with genotype 1 and approximately 75-85% with genotype 2 and 3. Peg-IFN/ribavirin combination therapy represents current standard therapy of chronic hepatitis C. This article reviews the treatment objectives, outcomes, optimal regimens, efficacy and predictors of response, monitoring during treatment, adverse events, retreatment of persons who failed to respond to previous treatments, and treatment of special patient groups in chronic hepatitis C.
Drug Therapy, Combination ; English Abstract ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/administration & dosage ; Interferon Alfa-2b/administration & dosage ; Polyethylene Glycols/administration & dosage ; Ribavirin/administration & dosage

No abstract available.
Antiviral Agents/*administration & dosage ; Drug Therapy, Combination ; Hepatitis C, Chronic/*drug therapy ; Humans ; Interferon Alfa-2b/*administration & dosage ; Ribavirin/*administration & dosage

OBJECTIVETo evaluate the efficacy and safety of telaprevir combined with peginterferon alfa (Peg-IFNa) plus ribavirin (RBV) (collectively, TPR therapy) in patients with chronic hepatitis C (CHC) using a meta-analysis approach.

METHODSThe Pubmed literature database was searched for randomized controlled trials of TRP therapy in CHC patients published between 2009 and 2011. The following outcome data was extracted for meta-analysis of efficacy: sustained virological response (SVR), defined as serum HCV RNA of less than 1000 copies/ml at end-of-treatment (week 24); rapid virological response (RVR), defined as serum HCV RNA of less than 1000 copies/ml at treatment week 4; recurrence, defined as serum HCV RNA of less than 1000 copies/mL at end-of-treatment and more than 1000 copies/ml at follow-up (week 24 after treatment completion). The pooled odds ratio (OR) or relative risk (RR) were calculated, with 95% confidence interval (CI). Heterogeneity was assessed by the Chi-squared test based on the Q statistic.

RESULTSSix studies of TPR triple therapy, representing a total of 2677 CHC patients, were included in the meta-analysis. Among the 1850 patients who received TPR, 56.3% (n = 1041) achieved RVR, 66.8% (n = 1235) achieved SVR, and 12.1% (n = 176/1460) experienced recurrence. Among the 827 patients who received PR double-therapy, 7.0% (n = 58) achieved RVR, 35.8% (n = 296) achieved SVR, and 32.3% (n = 145/449) experienced recurrence. The TRP group had significantly higher rates of RVR (OR = 29.83, 95% CI: 16.16 to 55.05) and SVR (OR = 3.97, 95% CI: 2.58 to 6.11) than the PR group (both P less than 0.01), and significantly lower rate of recurrence (RR = 0.36, 95% CI: 0.24 to 0.56, P less than 0.01).

CONCLUSIONThe therapeutic effect of research group is better than that of control group, suggesting that ornithine aspartate combined with naloxone treatment in hepatic encephalopathy is worthy of promoting.

Drug Therapy, Combination ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Oligopeptides ; administration & dosage ; therapeutic use ; Ribavirin ; administration & dosage ; therapeutic use ; Treatment Outcome

Adult ; Antiviral Agents ; administration & dosage ; Drug Therapy, Combination ; Female ; Goiter, Nodular ; complications ; drug therapy ; Hepatitis C, Chronic ; complications ; drug therapy ; Humans ; Interferon-alpha ; administration & dosage ; Ribavirin ; administration & dosage

Antiviral Agents ; administration & dosage ; Drug Therapy, Combination ; Hepacivirus ; drug effects ; genetics ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; administration & dosage ; adverse effects ; Ribavirin ; administration & dosage ; Treatment Outcome

No abstract available.
Antiviral Agents/*administration & dosage ; Combined Modality Therapy ; Genotype ; Hepacivirus/drug effects/genetics ; Hepatitis B, Chronic/*drug therapy ; Humans ; Interferon Alfa-2a/*administration & dosage ; Interferon Alfa-2b/*administration & dosage ; Polyethylene Glycols/*administration & dosage ; Ribavirin/*administration & dosage

OBJECTIVETo explore the effect of intensive treatment for refractory chronic hepatitis C, and to improve the sustained viral response (SVR) rate of treatment with interferon plus ribavirin by optimizing therapeutic dose and course.

METHODSPatients who did not acquire response or partial response by standard therapy (PEG-IFN alpha subcutaneous injection weekly plus Ribavirin 10.5 mg/kg) every day were enrolled and retreated with intensive treatment of 10 MU interferon every other day or 360 microg pegylated interferon alpha-2a weekly according to patients' wishes, and ribavirin 15 mg/kg every day. Serum HCV RNA was detected at baseline,treatment week 4, 12 and every 12 weeks succedent and 24 weeks after treatment end. Course of treatment was 72 to 96 weeks according to viral response. SVR was the mark of therapeutic effect.

RESULTS18 patients completed whole range therapy and follow-up, in which 12 patients acquired SVR, 5 patients treatment failure and 1 relapse. 3 patients acquired rapid viral response (RVR), and they all got complete Early Viral Response (cEVR) and SVR. RVR Patients' viral loads were significantly lower than that of patients who did not acquire RVR (t = 4. 687, P < 0.001). In 15 patients who did not acquire RVR, 8 patients acquired cEVR, and 9 acquired SVR. SVR rate of patients who were administered PEG-IFN alpha-2a was 4/5, 11 patients who acquired cEVR all acquired SVR, while in 7 patients who did not acquire cEVR, only 1 patient acquired SVR.

CONCLUSIONSHigh percent patients, who did not acquire response or partial response by previous standard antiviral therapy, could gain SVR by intensive dose interferon plus Ribavirin. In intensive treatment procedure, adjusting and prolonging course according to viral response after HCV RNA turned negative were important measures to improve refractory Chronic Hepatitis C SVR rate.

Adolescent ; Adult ; Antiviral Agents ; administration & dosage ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic ; drug therapy ; virology ; Humans ; Interferon-alpha ; administration & dosage ; Male ; Middle Aged ; Polyethylene Glycols ; administration & dosage ; RNA, Viral ; analysis ; Recombinant Proteins ; administration & dosage ; Ribavirin ; administration & dosage