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This article is part of the supplement: Proceedings of the Second Workshop of the Regional Study Group on HCV in the Calabria Region (Southern Italy). The virus-host-therapy pathway in HCV disease management: from bench to bedside in the era of Directly Acting Antivirals

Open Access Review

Therapeutic algorithms for chronic hepatitis C in the DAA era during the current economic crisis: whom to treat? How to treat? When to treat?

Salvatore Petta* and Antonio Craxì

Author Affiliations

Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Italy

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BMC Infectious Diseases 2012, 12(Suppl 2):S3  doi:10.1186/1471-2334-12-S2-S3

Published: 12 November 2012

Abstract

The advent of triple therapy (TT) with first-generation protease inhibitors boceprevir (BOC) and telaprevir (TVR) in addition to pegylated interferon and ribavirin resulted in a significant gain in terms of sustained virological response (SVR) when treating naive or previous treated patients with genotype 1 (G1) chronic hepatitis C (CHC). This gain is partly balanced by the increased complexity of treatment and by the raised costs and risks of therapy, making necessary to optimize the indication to TT.

Specifically, the identification of patient needing to TT over DT, the choice of the more correct therapeutic approach according to baseline and on treatment SVR predictors, and the timing of antiviral treatment, appear key issues to evaluate when considering TVR or BOC-based therapies.

Along this line, further efforts aimed to optimize the current TT regimens are still needed, especially in under-represented groups of patients in phase 3 studies such as those with cirrhosis, where post-marketing data are giving interesting evidences.