Hepatitis C therapies: A chronology of Past, Present and Future Hepatitis C therapies: A chronology of Past, Present and Future

Abstract

The key role of antiviral therapy of patients with chronic HCV is the sustained eradication of HCV. Different therapeutic plans such as herbal formulations against hepatitis symptoms were put forward for hundreds of years. However, lesser efficacy and, adverse effects constrained the large scale use of herbal medicines. The modern approach, thrived after the discovery of HCV made use of ‘‘interferon-based’’ regimens in different dose, duration of treatment and combination. After, ribavirin used in combination with interferon alpha became the centerpiece, pegylation of interferon alpha also aided in enhancing the efficacy of therapeutic plans. Keeping in view the genotype of HCV, viral load and virologic response to treatment, pegylated interferon alpha in combination with ribavirin soon became the standard of care for treating hepatitis C. Adverse effects and lower sustained virologic response rates associated with ‘‘interferon-based’’ regimen made indispensable the search for novel HCV therapies. The direct interference of some drugs in the HCV life cycle opened new gates to the treatment strategies beyond interferon. HCV NS3/4A protease inhibitors, the first developed class of Direct Acting Antivirals provided the modern world with Telaprevir and Boceprevir like drugs, that increased the SVR rates up to twice or thrice as that of Standard of Care alone. Many other important direct acting antivirals including polymerase inhibitors, alphaglucosidase and cyclophilin inhibitors, Nitazoxanide and immunomodulatory therapies proved effective in increasing the upshot rates of HCV therapies. Recent advancement saw the upstart of direct acting antiviral combination therapies and more direct actingdrugs under different phases of clinical trials.