Research Into New Hepatitis C Drugs
Interferon-based treatment does not work for everyone. Its benefits are limited by side effects that are daunting enough for some people to defer treatment until there are newer drugs.
However, it will take several years for new drugs to be tested and, if safe and effective, approved.
Waiting for better treatments may be a good option if you don't need HCV treatment now, if your liver is okay, and if HCV is not progressing quickly.
For a long time, research into HCV was difficult because, the virus couldn't be grown in laboratories. This changed recently when new models were developed to study the virus's life-cycle. This makes it easier to develop drugs that work both before the virus enters the cell, as well as when it is inside the cell.
Many new treatments for HCV are in development.
Some are oral drugs, from the same families as HIV medications (protease and polymerase inhibitors), though many of these drugs will not be active against HIV. These new drugs are likely to first be studied in people with HCV monoinfection, HCV treatment trials in coinfected people are expected in the near future, due to pressure from treatment advocates.
As with HIV drugs, combination therapy may be essential in order not to develop resistance, and a high level of adherence (taking over 95% of doses on time) is likely to be important.
To avoid resistance, new drugs will probably need to be used in combination with PEG interferon and ribavirin, until there are enough new drugs to construct interferon-free regimens. PEG interferon is likely to continue to be part of HCV treatment, but treatment may be able to compressed into a shorter period. Also, a small pilot study is starting with two oral drugs (an HCV protease inhibitor combined with an HCV polymerase inhibitor) to see if these can be safely used together, without standard of care. If all goes well, more combination studies will follow. To make an informed decision about starting or deferring HCV treatment, it is useful to know which new drugs are in development. Only brief details are included here of some of the compounds in development but the resources listed below can keep you up-to-date with this research.
Drugs that specifically target parts of the hepatitis C virus, protease and polymerase inhibitors, are currently in development. Some have made it into the clinic, others will follow. New formulations of interferon, which can be given less frequently, are being tested, as are immune-based therapies, and therapeutic and preventive vaccines. Drugs which generate an immune response, (called Mono-and polyclonal antibodies) are being studied in liver transplant recipients.
This article was provided by HIV i-Base. It is a part of the publication Hepatitis C for People Living With HIV. Visit HIV i-Base's website to find out more about their activities, publications and services.