The goal of HCV treatment is to cure the virus, which can be done with a combination of drugs. The specific meds used and the duration of treatment depend on a number of factors, including HCV genotype (genetic structure of the virus), viral load, past treatment experience, degree of liver damage, ability to tolerate the prescribed treatment, and whether the person is waiting for a liver transplant or is a transplant recipient. In some cases, HCV treatment may be limited by your health insurance plan or drug formulary.
Here's more specific information about each type, or class, of approved HCV treatment along with drugs in the late stages of development (Click here for a printable PDF version):
What are they? Interferon is a protein made by the immune system, named because it interferes with viral reproduction. In addition, interferon signals the immune system to recognize and respond to microorganisms, including viral and bacterial infections. Infected cells release interferon to trigger the immune response. There are three types of interferon: alfa, beta and gamma. Interferon alfa is used to treat viral hepatitis and some types of cancer.
What are they? Although it is not effective against hepatitis C when used alone, ribavirin plays an important role in HCV combination treatment. Scientists have not determined exactly how it works. However, it is clear that combining ribavirin with pegylated interferon boosts cure rates and reduces the risk of relapse.
What are they? Protease inhibitors (PIs) block a protein that plays a critical role in HCV replication: They bind to the viral protease, which is responsible for processing viral proteins. Olysio is used to treat HCV genotype 1 and is taken once a day. The first generation of HCV protease inhibitors, Incivek and Victrelis, are also only used to treat HCV genotype 1 but must be taken three times a day. Future protease inhibitors may be potentially effective against other HCV genotypes.
Nucleoside and Nucleotide NS5B Polymerase Inhibitors
What are they? These drugs block the NS5B protein, which plays a role in the replication of HCV and is involved in creating copies of the viral RNA genome. Sovaldi is used to treat HCV genotypes 1, 2, 3 and 4 and is currently being researched as part of a once-a-day combination pill with the NS5A inhibitor ledipasvir for the treatment of genotype 1; Phase III studies have been very promising. If approved, the combination pill should be available by late 2014.
What are they? NS5A is an HCV protein, a part of the HCV replication complex (replicase), with multiple functions in the virus's life cycle. These inhibitors are currently being studied in combination with agents in other drug classes and show potential for use as a component of interferon- and ribavirin-free regimens.