Chapter 25

Treatment of Hepatitis C

Christoph Welsch

Christoph Welsch

J.W. Goethe University Hospital, Frankfurt am Main, Germany

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Stefan Zeuzem

Stefan Zeuzem

J.W. Goethe University Hospital, Frankfurt am Main, Germany

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First published: 26 July 2013

Summary

The goal of hepatitis C virus (HCV) therapy is viral eradication to prevent complications of chronic infection. The sustained virologic response rate for pegylated interferon alpha (PEG-IFNα) plus ribavirin (RBV) has been only about 50% in patients infected with HCV genotype 1, the most prevalent genotype in Europe and North America. Therapy has been revolutionized recently by the development and approval of direct-acting antiviral agents (DAAs). Triple therapy with PEG-IFNα, RBV, and a protease inhibitor has supplanted PEG-IFNα and RBV alone as the new standard of care (SOC) for HCV genotype 1 infection. This chapter provides an overview on chronic hepatitis C treatment, including dosing regimens, response rates, stopping rules, side effects, drug resistance development, and medication interactions. A perspective on novel agents in clinical development and interferon-sparing regimens concludes this chapter.

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