Clinical Gastroenterology Vol.31 No.11(3-4)

Theme Interferon-free Treatment of Hepatitis C
Title Significance of Pegylated Interferon and Ribavirin in Combination with Direct-Acting Antiviral Agents
Publish Date 2016/10
Author Yasuhiro Asahina Department of Gastroenterology and Hepatology, Department of Liver Disease Control, Tokyo Medical and Dental University
[ Summary ] In 2014, the first interferon‒free and all‒oral regimen which combined an NS3/4A protease inhibitor and an NS5A inhibitor, was initiated in Japan. This phase III trial reported that all‒oral regimens were well tolerated in patients, with a low incidence of serious adverse effects and high sustained virological response (SVR) rates, in the range of 80‒90 %. After this early evidence was demonstrated, suggesting that combination therapy with direct‒acting antiviral agents, without interferon may offer fewer side effects and higher SVR rates, anti‒HCV therapy has entered a new era of interferon‒free regimens. However, these new regimens also may introduce issues such as affordability and accessibility, the emergence of drug‒resistant HCV mutants, and hepatocarcinogenesis after SVR has been achieved. Therefore, treatment with interferon in combination with direct‒acting antiviral agents is still of great value because of its cost-effectiveness, ability to lower drug‒drug interactions, lower rate of emergence of resistant mutants, and suppressive effect on carcinogenesis.
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