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Treatment of HCV in Patients who Failed First-Generation PI Therapy: a Review of Current Literature

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Abstract

The addition of the first direct-acting antiviral agents, the NS3 protease inhibitors boceprevir or telaprevir, to peg interferon and ribavirin was a major advance in the treatment of genotype 1 hepatitis C individuals with sustained virological response (SVR) rates of 63–75 %. Those who did not achieve SVR had high rates of resistance-associated variants against NS3 protease domain. Retreatment options for those who have failed first-generation protease inhibitors generally are guided by retreatment with direct-acting antiviral agents from other classes. Phase 2 and phase 3 data have demonstrated that retreatment with 12–24 weeks of a NS5B inhibitor (sofosbuvir) in combination with a NS5a inhibitor (daclatasvir or ledipasvir) with or without ribavirin can achieve SVR at high rates comparable to treatment-naive individuals.

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Conflict of Interest

Maaz B. Badshah declares no conflict of interest.

Dr. Kwo reports grants and personal fees from Abbvie, grants and personal fees from BMS, grants and personal fees from Merck, grants and personal fees from Vertex, grants and personal fees from Janssen, grants from Conatus, grants from Roche, personal fees from GlaxoSmithKline, personal fees from Novartis, and grants and personal fees from Gilead, outside the submitted work.

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  1. Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, 975 W. Walnut, IB 327, Indianapolis, IN, 46202-5121, USA

    Paul Y Kwo

  2. Department of Medicine, Division of General Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Maaz B. Badshah

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Kwo, P.Y., Badshah, M.B. Treatment of HCV in Patients who Failed First-Generation PI Therapy: a Review of Current Literature. Curr Gastroenterol Rep 17, 40 (2015). https://doi.org/10.1007/s11894-015-0462-0

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