Review article: Novel therapeutic options for chronic hepatitis C

Abstract

Background: The efficacy of treatment against hepatitis C virus has improved, but it is still far from ideal. Thus, new antihepatitis C virus therapies are required. Aim: To evaluate the data on antihepatitis C virus approaches beyond the current standard combination of pegylated interferon-alpha and ribavirin. Method: We reviewed the available literature regarding novel antihepatitis C virus options, given alone or in combination with existing agents. Results: New interferons and ribavirin alternatives have been tried aiming to improve the efficacy and the safety/tolerability profile of standard agents. The hepatitis C virus polymerase and NS3/4A protease have been rather popular targets for new antihepatitis C virus agents. The combination of such inhibitors with pegylated interferon-alpha and ribavirin seems to act synergistically and to prevent viral resistance, compared to monotherapies. Several novel immunomodulators are currently evaluated and may be useful in combination therapies. Alternative strategies (inhibition of hepatitis C virus protein translation, assembly/release or binding) or agents with different modes of action (statins, S-adenosylmethionine and herbs) need further evaluation. Conclusions: Many novel promising antihepatitis C virus agents are being developed, offering hope for future therapies that may target multiple points of the viral life cycle and/or host immune response. Newer approaches should ideally provide safe, effective and more tolerable therapy to all chronic hepatitis C virus patients. © 2008 The Authors.