Premium
Treatment of patients with genotype 3 chronic hepatitis C ‐ current and future therapies
Author(s) -
Sarin Shiv K.,
Kumar Chandan K. N.
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02715.x
Subject(s) - ribavirin , medicine , genotype , pegylated interferon , gastroenterology , hepatitis c , steatosis , viral load , hepatitis c virus , immunology , antiviral therapy , chronic hepatitis , virus , biology , gene , biochemistry
Abstract Genotype 3 is a common type of HCV infection, and standard therapy using pegylated interferon ( PEG ‐ IFN ) and ribavirin ( RBV ) is quite effective in these patients. While a short course of 16 weeks may result in comparable end of therapy responses, relapse rates are often high. A 24‐week course is therefore preferable, and is expected to result in sustained virological response ( SVR ) rates of more than 70%. The 24‐week course is especially recommended in the presence of steatosis (often associated with Genotype 3 infection), fibrosis stage two or more, high BMI and high viral load. In patients who do not achieve a rapid viral response ( RVR ) with combination therapy, an extended course up to 48 weeks should be considered. While not as definite as for genotype 1 patients, the presence of the CC variant of IL28b could help in the initial prognosis and the need for additional treatment, if an RVR is not achieved. The role of directly acting antiviral agents ( DAA ) has not been fully evaluated in treatment naïve, non‐responders and relapsers in genotype 3 patients. Initial results with the cyclophilin inhibitor D ebio‐025 are quite encouraging. There is an urgent need for large clinical trials using DAA and host modulators in patients with G3 infection.