The hepatitis C viral (HCV) infection is a global health burden, WHO estimates 130–150 million people chronically infected with hepatitis C virus worldwide. Additional 3–4 million people become newly infected annually and more than 350,000 people die each year of HCV-related liver diseases. HCV infection exhibits higher genetic diversity with regional variations in genotypic prevalence resulting big challenges on disease management. Introduction of DAAs revolutionised the new era of all oral therapy in treatment of chronic hepatitis C infection and is the regimens of choice in present days. However, IFN-based combination therapy with sofosbuvir has promising efficacy in genotypes 3, 4, 5 or 6 infections compared to genotypes 1 and 2 infections. So, these regimens could be an option in DAAs regimen failure cases. The poor availability of data on recent DAAs (IFN-free) regimens questioned on regular use and cost effectiveness is the another challenge with DAAs regimens. So phase III trials (sofosbuvir and velpatasvir) of recent DAAs with pangenotypic actions and better tolerability in HCV infected patients are the future advances in treatment of chronic hepatitis C. After all those recent combination therapies with better SVR, the combination of pegylated interferon with ribavirin is the only option available where unavailability of other regimens still exists.
Part of the book: Advances in Treatment of Hepatitis C and B