Interview with Gary L Davis.

The recent approval of two protease inhibitors (telaprevir and boceprevir) and the resultant increase in the sustained virological response (SVR) rate when either of these drugs is added to pegylated interferon (PEG-IFN) and ribavirin (RBV) have led to a flurry of patients with hepatitis C virus (HCV) infection seeking treatment.

Treatment failure with pegylated interferon (PEG-IFN)/ribavirin (RBV) dual therapy can be due to either the persistence of hepatitis C virus (HCV) RNA throughout treatment (nonresponse) or the reappearance of the virus after the end of treatment.

As soon as it was recognized that interferon-based therapy could lead to long-term viral eradication or a sustained virological response (SVR), the search was on for predictors of responses to therapy. With low response rates and the need for prolonged, costly, and difficult therapy, the primary goal was to identify patients who were unlikely to respond to treatment so that fruitless therapy could be avoided.

The recent development of direct-acting antiviral (DAA) molecules that are active on hepatitis C virus (HCV) has raised the concern that resistance may undermine therapy based on DAAs.

Interview with Nezam H. Afdhal.

Major challenges encountered in Hepatitis C treatment include selecting suitable patients for treatment, the optimal approach in the individual patient, and the utilization of an experienced, usually multi-disciplinary team to ensure safe and effective patient outcomes.

There are significant challenges to the use of DAAs in patients with HIV/HCV confection, including the potential for interactions between different drugs, addition of drug toxicities, and the ongoing need for therapy with peginterferon.

Cirrhosis develops in up to 25% of patients infected with Hepatitis C over a 30-year period.

Interview with K Rajender Reddy