Treatment of hepatitis C virus infection: From therapy with interferon to direct-acting antivirals

Abstract

Hepatitis C virus (HCV) infection is a global public health concern. An es-timated of 58 million people with chronic HCV infection are at risk of developing cirrhosis or hepatocellular carcinoma. Since the discovery of HCV in 1989, the search for a treatment to achieve viral clearance has been one of the main research goals, which is why this review focuses on the different treatments for HCV infection. In the 80s, therapies with interferon-α, and pegylated interferon-α in monotherapy or combination with ribavirin began. However, sustained viral response (SVR) was achieved in a limited percentage of patients. First-generation direct-acting antivirals (DAAs) were approved in 2011, and new DAAs with SVR rates greater than 95% were developed in the last 10 years. However, mutations associated with resistance to DAAs have recently been reported, especially in HCV genotypes 1, subgenotype 1a, and 3. Finally, it is important to note that viral clearance after DAA treatment does not eliminate the risk of hepatocellular carcinoma in patients with liver cirrhosis.