Tremendous progress has been made in the field of antiviral treatment for hepatitis C virus (HCV) infection since the identification of the virus in 1989. Although early treatment regimens with interferon (IFN) alone achieved only limited success, the addition of the broad-spectrum antiviral agent ribavirin has greatly improved response. The primary goal of treatment for HCV infection-viral eradication-is best achieved when the viral level is reduced substantially during the early phase of treatment.Viral eradication is expressive of sustained virological response, the benefits of which are multifactorial and include improved hepatic histology: a decreased occurrence of hepatocellular carcinoma or liver failure and a lower probability of liver-related mortality. Treatment of HCV infection with the current "gold standard" of care-pegylated IFN in combination with ribavirin-is associated with an approximately 50% overall rate of viral eradication, a great improvement over previous IFN treatment regimens. However, more effective and better-tolerated treatments are needed for patients with unfavorable treatment profiles, such as genotype 1, a high viral level at baseline, hepatic steatosis, and poor adherence to treatment due to severe side effects.
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