Treatment of genotype 3 chronic hepatitis C virus infection

Abstract

Genotype 3 (GT3) hepatitis C virus (HCV), the second most common HCV genotype worldwide, has emerged as the most difficult-to-cure genotype. Sustained virological response (SVR) rates with new direct-acting antiviral regimens for GT3 patients who are treatment-naïve and noncirrhotic are now similar to those seen in patients with non-GT3 HCV infection. However, GT3 HCV patients who are treatment-experienced or who have cirrhosis, particularly those with decompensated disease, continue to be a more challenging group to treat due to lower SVR rates. Here, we review the current evidence for the treatment of patients with GT3 HCV including current data for patients with GT3 HCV who are HIV coinfected. Future studies in GT3 HCV treatment will need to focus on direct-acting antiviral combinations that improve cure rates and potentially eliminate the need for ribavirin in GT3 patients who have advanced liver disease. The significance of HCV resistance-associated variants in GT3 HCV patients who have failed prior treatment also needs further assessment to help guide re-treatment strategies.