Interferon Free Therapy for Hepatitis C!

In the last few weeks the FDA approved two new antiviral agents for hepatitis C--a scourge that infects over 3 million Americans and is the leading cause for the need for liver transplantation. 

For years the standard treatment for hepatitis C virus had been a combination of two drugs, interferon via injection and ribavirin, taken for up 24- 48 weeks (depending on which genotype of hepatitis C virus is present). These medications had serious side effects including depression, anemia, and flu-like symptoms causing many individuals to stop treatment early. 

A few years ago, the landscape of hepatitis C changed with the approval of two new drugs to be used in combination with interferon and ribavirin in the treatment of the most common type (genotype 1) of hepatitis C. These protease inhibitors, boceprevir and telaprivir, have improved treatment response rates and can, in some instances, decrease the duration of treatment. Last month, the FDA approved simeprevir a once-daily protease inhibitor that can also be used in combination with interferon and ribavirin.

The 2nd drug the FDA  approved is sofosbuvir, a potential pathbreaking nucleotide analog.  The excitement over this drug stems from the fact that it can be administered in an interferon-free regimen, sparing patients months of dreadful side effects. Interferon-free regimens are restricted to genotype 2 and 3 infections. For genotype 1 infections, triple therapy with an interferon backbone remains the preferred treatment  because clinical trial data does not support the use of interferon-free regimens.