Recent Advances in Pegylated Interferon Antiviral Therapy of Chronic Hepatitis C

ISSN: 2211-3533 (Online)
ISSN: 2211-3525 (Print)


Volume 14, 2 Issues, 2016


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Anti-Infective Agents

Formerly: Anti-Infective Agents in Medicinal Chemistry

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Recent Advances in Pegylated Interferon Antiviral Therapy of Chronic Hepatitis C



Anti-Infective Agents, 5(4): 379-387.

Author(s): Carla S. Coffin and Samuel S Lee.

Affiliation: Room 1721, Health Sciences Centre, Liver Unit, Division of Gastroenterology, 3330 Hospital Drive NW,University of Calgary, Calgary, Alberta T2N 4N1, Canada.

Abstract

Effective hepatitis C antiviral treatment is important given the significant global morbidity and mortality from liver-related complications. Therapy for hepatitis C has advanced remarkably in the past two decades starting with interferon- alpha (IFN) monotherapy, followed by genetically engineered recombinant interferons (consensus IFN alpha) and subsequently IFN alpha in combination with the nucleoside analog ribavirin. The current gold standard is a combination of long-acting pegylated interferon (PEG-IFN) with ribavirin achieving a sustained virological response (SVR) with acceptable safety profiles in 54-66% of patients. These therapies have significantly contributed to our armamentarium against hepatitis C virus infection. Despite this success some subgroups have lower response rates (i.e. previous IFN nonresponders, patients with genotype 1 or cirrhosis). Moreover, the question of a “true SVR ” has been raised. Recent studies confirming detection of residual HCV RNA using ultra-sensitive polymerase chain reaction (PCR) based assays in patients many years after complete clinical resolution of chronic hepatitis C raise concerns whether these patients have actually been cured. In this paper we review the natural history, epidemiology and basic virology of hepatitis C. Current treatments and long-term benefits of achieving a SVR, including the antiviral and anti-inflammatory effects of IFN are also explored. Finally, we review the current understanding of persistent occult viremia in patients apparently cleared of HCV after achieving SVR with antiviral treatment.

Keywords:

Peginterferon, ribavirin, sustained virological response, occult, persistence.



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Article Details

Volume: 5
Issue Number: 4
First Page: 379
Last Page: 387
Page Count: 9
DOI: 10.2174/187152106778520415
Price: $58
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