Perspectivas futuras en el tratamiento de la hepatitis crónica C

Abstract

The main lines of research into new drugs and treatment strategies against type C viral hepatitis are described. This disease is a major public health problem, with more than 700,000 people affected by the illness in Spain and with a high degree of prevalence amongst prison inmates. Limitations on current treatment for viral hepatitis C have led to research into new drugs in the form of two main product lines, some of which are soon to be available on the market: NS3/4ª serine-protease inhibitors (telaprevir, boceprevir, danoprevir and vaniprevir) and the NS5B RNA polymerase inhibitors (RG-7128, RG-7227, Filibuvir, ANA-598). The latter are in a somewhat earlier stage of development. It is expected that these new drugs will have to be used alongside the current standard treatment of pegylated interferon plus ribavirin and under these conditions of use the new drugs have already shown greater effectiveness than the current standard treatment. Despite this encouraging perspective, the new medicines have limitations such as the development of resistances, toxicity, and the little knowledge available of their effectiveness on viral genotypes that are different from 1. That being said, their appearance opens up new possibilities in the treatment of this disease.

Interferon treatment of chronic hepatitis C: Basic immunobiology and immunopathology of the liver

“…Moreover, strategies are needed to improve the results in patients infected with treatment-resistant HCV genotypes. In patients with chronic hepatitis C and null response to standard treatment regimens there are direct antiviral alternatives such as Boceprevir and Telaprevir available for triple therapy retreatment 14 along with other antiviral drugs in phase of R&D 15 which have achieved SVR rates of over 60% in clinical trials. Some of the experimental data suggest a synergic mechanism in the coinfection by HCV and HIV between the regulation of the expression of Fas in CD4+ T cells induced by HIV and high levels of FasL both soluble and in cells.…”