Updates in the management and treatment of HCV genotype 3, what are the remaining challenges?

ABSTRACT

Introduction: Chronic hepatitis C (CHC) genotype-3 (G-3) infection is the next most prevalent genotype with 54.3 million patients globally. It is associated with an increasing risk of fibrosis, liver-related events, hepatocellular carcinoma, and overall mortality. G-3 infection may have a negative impact on histological and clinical outcomes in CHC patients. In addition, its characteristic features of steatosis and metabolic abnormalities may add more difficulty in the disease management.

Area covered: Fortunately, the landscape of management has been drastically changed in the past decade with the blooming of all oral direct antiviral agents (DAAs). The extremely high efficacy, high safety, short treatment duration, low adverse effects, and easy dosing of DAAs provide an excellent exploration of medical therapeutics in human history. The review consisted of the updated management of CHC G-3, and also touched upon what are the remaining challenges currently. Some challenges and unmet needs were also raised in a clinical setting, including treatment barriers, clinical outcomes, and metabolic abnormalities.

Expert commentary: There is a pressing need for management of G-3 infection because of its large patient burden and poor clinical outcomes than other genotypes. Further investigation is warranted in terms of its treatment barriers and clinical outcomes.

KEYWORDS:

• Direct antiviral agents
• genotype 3
• hepatitis C virus
• hepatocellular carcinoma
• metabolic disorders
• patient outcomes

Declaration of interest

W-L Chuang is on an advisory board for Gilead, BMS, AbbVie, MSD, and PharmaEssentia.; and is a speaker for Gilead, BMS, AbbVie, MSD, PharmaEssentia.

M-L Yu received research grants from Abbvie, BMS, Gilead, Merck and Roche; Consultant and/or speaker of Abbvie, Ascletis, BMS, Gilead, Merck, Novartis, Pharmaessential and Roche. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was supported partly by grants from the Ministry of Science and Technology, Taiwan [MOST104-2314-B-037-078-MY3] and Kaohsiung Medical University Hospital [KMUH105-5R04, KMUH106-6R07]. The authors also thank secretary help from Taiwan Liver Research Foundation (TLRF). The foundation did not influence the approval of the manuscript.