Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 28, 2015; 7(12): 1617-1631
Published online Jun 28, 2015. doi: 10.4254/wjh.v7.i12.1617
Predictive factors associated with hepatitis C antiviral therapy response
Lourianne Nascimento Cavalcante, André Castro Lyra
Lourianne Nascimento Cavalcante, André Castro Lyra, Hospital Sao Rafael - Gastro-Hepatology Service, Salvador, Bahia 41253-190, Brazil
André Castro Lyra, Department of Medicine, Federal University of Bahia, Salvador, Bahia 40026-010, Brazil
Author contributions: Cavalcante LN and Lyra AC contributed equally to this work.
Conflict-of-interest: The authors have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lourianne Nascimento Cavalcante, MD, Hospital Sao Rafael - Gastro-Hepatology Service, Diretoria Científica, 6° andar Sao Rafael Av. 2152 - Sao Marcos, Salvador, Bahia 41253-190, Brazil. lourianne@gmail.com
Telephone: +55-71-32816432 Fax: +55-71-32816855
Received: August 28, 2014
Peer-review started: August 29, 2014
First decision: November 14, 2014
Revised: December 16, 2014
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: June 28, 2015
Abstract

Hepatitis C virus (HCV) infection may lead to significant liver injury, and viral, environmental, host, immunologic and genetic factors may contribute to the differences in the disease expression and treatment response. In the early 2000s, dual therapy using a combination of pegylated interferon plus ribavirin (PR) became the standard of care for HCV treatment. In this PR era, predictive factors of therapy response related to virus and host have been identified. In 2010/2011, therapeutic regimens for HCV genotype 1 patients were modified, and the addition of NS3/4a protease inhibitors (boceprevir or telaprevir) to dual therapy increased the effectiveness and chances of sustained virologic response (SVR). Nevertheless, the first-generation triple therapy is associated with many adverse events, some of which are serious and associated with death, particularly in cirrhotic patients. This led to the need to identify viral and host predictive factors that might influence the SVR rate to triple therapy and avoid unnecessary exposure to these drugs. Over the past four years, hepatitis C treatment has been rapidly changing with the development of new therapies and other developments. Currently, with the more recent generations of pangenotipic antiviral therapies, there have been higher sustained virologic rates, and prognostic factors may not have the same importance and strength as before. Nonetheless, some variables may still be consistent with the low rates of non-response with regimens that include sofosbuvir, daclatasvir and ledipasvir. In this manuscript, we review the predictive factors of therapy response across the different treatment regimens over the last decade including the new antiviral drugs.

Keywords: Hepatitis C, Direct acting antivirals, Antiviral therapy, Interferon, Sustained virologic response

Core tip: Treatment of chronic hepatitis C has been changing very rapidly in recent years. The chances of cure have increased with the new drugs. Predictive factors of sustained treatment response in the “age” of based-interferon therapy is becoming less important with the arrival of the direct acting antivirals, however, viral genotype, cirrhosis and viral kinetics may still impact on therapy outcome with the new available drugs.