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Treatment for Hepatitis C Virus Infection in Adults: Comparative Effectiveness

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Background: Currently Available Treatments for Chronic Hepatitis C Virus Infection in Adults

In the early 2000s, the combination of either pegylated interferon alfa-2a or alpha-2b with ribavirin became the standard antiviral treatment for hepatitis C virus (HCV) infection. Currently, two pegylated interferons are available: pegylated interferon alfa-2a and pegylated interferon alfa-2b. The dosing schedule is fixed for pegylated interferon alfa-2a and is based on weight for pegylated interferon alfa-2b. Dual therapy with pegylated interferon (alfa-2a or alfa-2b) plus ribavirin is associated with higher sustained virologic response rates (about 55–60% overall) than pegylated interferon (alfa-2a or alfa-2b) monotherapy. Both combinations are associated with a high rate of adverse effects.

In 2011, the U.S. Food and Drug Administration approved the first direct-acting antiviral agents, boceprevir (trade name Victrelis®) and telaprevir (trade name Incivek®), for treating chronic HCV genotype 1 infection. Both drugs are classified as nonstructural 3/4A protease inhibitors. Each drug can be administered in combination with pegylated interferon (alfa-2a or alfa-2b) plus ribavirin.