Treatment Of Hepatitis

Hepatologist in 1988 there were no treatments for viral hepatitis. In fact, hepatitis C (HCV), then known as non-A, non-B (NANB) hepatitis, was not discovered until the following year. Almost a decade passed before treatment for HCV became available that resulted in acceptable Sustained Virologic Response (SVR) rates (now known to be consistent with virologic cure) - a combination of Interferon alpha (IFN) plus Ribavirin (RBV). Prior to this pairing, less than 10% of HCV patients achieved a SVR when treated with IFN alone. With combination therapy, SVR rates rose to approximately 40-50%. IFN plus RBV or PEGylated IFN (PIFN) plus RBV have been the backbone of HCV therapy since this time. Identification of additional improved therapeutics with fewer Adverse Events (AEs), higher SVR rates and shorter treatment durations, was hampered by the inability to grow HCV in tissue culture and by the lack of robust small animal models. Development of a selectable HCV replicon cell culture system in 1999 significantly accelerated the drug discovery process. Since this time, a plethora of small molecules capable of inhibiting HCV RNA replication have been identified and have advanced into phase II and III clinical trials. We will soon be entering an exciting new era of therapy for HCV, one in which most patients can expect to be cured without the use of interferon. However, this gives rise to the question -“What role will ribavirin play in future treatment regimens?”

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Last date updated on April, 2024