Update of old and emerging therapies in chronic hepatitis C

The main aim in treating hepatitis C virus (HCV) infection is to achieve a sustained virological response (SVR). It is defined as undetectable HCV-RNA in peripheral blood 24 weeks after the end of treatment. The RNA is detected by polymerase chain reaction (PCR) technique. The SVR practically reflects eradication of HCV infection and cure of the underlying HCV-induced liver disease. Treatment of HCV-induced chronic hepatitis includes one of the available Interferon-α (INF-α) in combination with Ribavirin (RBV). To achieve much better results, combination of PEG-INF with RBV is currently recommended. This regimen is quite effective in treating HCV genotype 2 and 3 but much less so in genotypes 1 and 4. At the same time it has long been observed that these combinations have sometimes severe side effects and contraindications limiting their efficacy and applicability in a significant number of chronic HCV patients. Therefore, the importance of improving existing therapies and developing new, effective, safe and tolerable drugs is well appreciated, worldwide. This review describes improvements in the current standard therapy and new emerging drugs.