Reviews and PerspectivesReviews in Basic and Clinical Gastroenterology and HepatologyNew Hepatitis C Therapies: The Toolbox, Strategies, and Challenges
Section snippets
Pegylated IFNα and Ribavirin
Pegylated IFNα will remain the backbone of some HCV treatment strategies in 2014 and 2015, before slowly but definitively disappearing from HCV treatment regimens—at least in areas of the world that will be able to afford the high cost of IFN-free combinations. Ribavirin can be used to increase rates of sustained virologic response (SVR) (ie, rates of infection cure) or to shorten treatment duration without altering the rates of SVR with both pegylated IFNα and IFN-free regimens, because it
Strategies
In 2014 and 2015, new IFN-containing and IFN-free regimens will become available. Starting in 2015 and onward, IFN-containing regimens will be replaced by all-oral, IFN-free therapies, at least in areas of the world where these regimens are approved and their cost is covered.
Unsolved Scientific Questions
A number of unsolved scientific questions remain. They will need to be explored within the next months to years.
Conclusions
The treatment of HCV infection will change dramatically in 2014–2015 and onward. Many unresolved scientific questions will never be answered because new therapeutic approaches will replace existing ones within a short timeframe until the field stabilizes, probably with the next generation of HCV drugs still at the preclinical or early clinical developmental stages. Pragmatic approaches based on careful interpretation of existing data and the generation of small-scale postapproval studies
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Conflicts of interest Jean-Michel Pawlotsky has received research grants from Gilead Sciences and has served as an advisor for Abbott, Abbvie, Achillion, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Idenix, Janssen, Merck, Novartis, and Roche.
Funding Jean-Michel Pawlotsky's work is funded by the National Agency for Research on AIDS and Viral Hepatitis (ANRS), the Fondation pour la Recherche Médicale (FRM), the Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Est (UPEC).