Hepatitis C: Treatment of difficult to treat patients

Table 1 Chronologically listed, Food and Drug Administration approved treatment regimens for hepatitis C virus

HCV (identified in 1989)
Approved drugs 1991-2001
Interferon (approved in 1991)
RBV + standard interferon (1998)
Peg-IFNs (approved in 2001)
Peg-IFN
Peg-IFN + RBV
DAAs 2011-present
Telaprevir and boceprevir
Increase SVR rates and provide the option of response-guided therapy and retreatment for genotype 1 patients
Telaprevir + peg-IFN + RBV, genotype 1 only (2011)
Boceprevir + peg-IFN + RBV, genotype 1 only (2011)
Sofosbuvir
Approved for use in all genotypes. High SVR rates with better tolerability, shorter duration, use in HIV-HCV co-infection, and first interferon-free all-oral regimen in genotype 2, 3 and certain other patients
Sofosbuvir + peg-IFN + RBV, in genotype 1 only (2013)
Sofosbuvir + RBV, without interferon, in genotype 2 and 3, in HIV-HCV co-infection, with any genotype, and in selected situations of genotype 1 (2013)
Simeprevir
High SVR rates with better tolerability and shorter duration for genotype 1
Simeprevir + peg-IFN + RBV, in genotype 1 only (2013)

Adapted from http://www.hepatitis.va.gov. DAAs: Direct acting antivirals; SVR: Sustained virological response; HIV: Human immunodeficiency virus; HCV: Hepatitis C virus; RBV: Ribavirin; Peg-IFN: Pegylated interferon.