Hepatitis C: The recovery

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Gastroenterol Clin Biol. 2009 Jun 19. [Epub ahead of print]

[Hepatitis C: The recovery.]

[Article in French]

Marcellin P.

Inserm U773 CRB3, service d'hépatologie, université de Paris-7, hôpital

Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France.

After the discovery of the hepatitis B virus in 1968 and of the hepatitis A

virus in 1973, many years were needed to identify the hepatitis C virus (HCV) in

1989. The discovery of HCV was a revolution for hepatology because of the

magnitude of the global burden related to HCV infection, a major cause of

cirrhosis and hepatocellular carcinoma. Therapy of hepatitis C has rapidly

evolved with currently nearly 60% of sustained virological response with the

combination of pegylated interferon plus ribavirin. In patients with sustained

virological response, viral eradication, corresponding to the cure of infection,

and regression of histological liver lesions have been demonstrated. Recently,

the availability of in vitro culture systems allowed to characterize viral

enzymes, potential therapeutic targets. A novel therapeutic era is open with the

protease and polymerase inhibitors, used as a first step in association with

pegylated interferon and ribavirin, both to increase efficacy and decrease the

risk of resistance. Thanks to these new molecules with a potent antiviral

activity, one can reasonnably predict a rapid improvement of treatments becoming

more efficient and also better tolerated with the progressive replacement of

interferon and ribavirin by combinations of these virus specific enzyme

inhibitors.

PMID: 19541439