History of Treatment for Hepatitis C - In the Era When Cure Is Achieved with Oral Drugs -

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In Japan, some 30,000 people every year die from liver carcinoma. Approximately 65% of hepatocellular carcinomas (HCC) are caused by hepatitis C. Therefore, the treatment of hepatitis C is important. As an antiviral therapy for hepatitis C virus (HCV), interferon (IFN) monotherapy was initiated in the 1990s. Thereafter, combination therapy of IFN with the oral antiviral drug ribavirin (RBV) became available in December 2001, followed by pegylated IFN (PEG-IFN) in December 2003. Combination therapy of PEG-IFN with RBV for HCV genotype (GT) 1 infection was initiated in December 2004, and this combination therapy had been the standard therapy until 2011. The development of direct acting antivirals (DAAs) represents a major breakthrough in the treatment of HCV-infected patients. Since the end of 2011, triple therapy of protease inhibitor combined with PEG-IFN and RBV has markedly improved treatment outcome in HCV-infected patients. In September 2014, IFN-free DAA therapies became available for patients with chronic hepatitis C and HCV-related cirrhosis of Child-Pugh class A. In these patients, DAA therapies achieve an HCV-RNA undetectable rate of approximately 95%. The final goal of treatment for chronic hepatitis C is viral eradication and prevention of progression to cirrhosis and HCC. The goal of hepatitis C eradication has almost been reached.