Next Generation Direct-acting Antiviral Agents for Hepatitis C Treatment

Paul Y. Kwo, MD, Marco Lacerda, MD


Sofosbuvir in combination with peginterferon and ribavirin for 12 weeks is a new treatment paradigm with a 12 week course of therapy leading to high sustained response rates in genotype 1 and 4  infected individuals including high sustained response rates in cirrhotic patients.  In addition, genotype 2 and 3 infected individuals now have an all oral regimen of sofosbuvir and ribavirin, which is highly effective in all genotype 2 infected individuals with 12 weeks of therapy.  For genotype 3 infected individuals, 24 weeks of the sofosbuvir  and ribavirin leads to high sustained virological response rates in most  groups.  However, cirrhotic genotype 3 infected individuals are going to require additional strategies to optimize SVR rates. It is expected that 2014 should see the presentation of phase 3 data with a variety of combinations of direct acting antiviral agents with the anticipated approval of these combinations occurring in late 2014 or early 2015.  Moreover, one should expect that SVR rates above 90% for treatment naive and treatment failure patients should be the expected norm for all patients.


hepatitis C, antiviral, genotype 1 treatment, Sofosbuvir, peginterferon, ribavirin

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