Direct-acting antivirals

Direct-acting antivirals (DAA) are drugs used to treat hepatitis C infections. They are a combination of antiviral drugs that target stages of the hepatitis C virus reproductive cycle. They are more effective than older treatments such as ribavirin and interferon. The DAA drugs are taken orally, as tablets, for 8 to 12 weeks.[1] The treatment depends on the type or types (genotypes) of hepatitis C virus that are causing the infection.[2] Both during and at the end of treatment, blood tests are used to monitor the effectiveness of the treatment and subsequent cure.[1]

The DAA combination drugs used include:[3]

  • Epclusa (sofosbuvir and velpatasvir)
  • Harvoni (ledipasvir and sofosbuvir)
  • Zepatier (elbasvir and grazoprevir)
  • Mavyret (glecaprevir and pibrentasvir)
  • Vosevi (sofosbuvir, velpatasvir, and voxilaprevir)

DAAs were approved on the basis of a surrogate endpoint called "Sustained virological Response" or SVR.[4] Although SVR is widely marketed as a functional "cure," its validity for predicting clinical outcomes (liver disease. extending life) has been challenged,[5][6]

References
  1. "Overview-Hepatitis C". National Health Service, UK. 21 June 2018.
  2. González-Grande R, Jiménez-Pérez M, González Arjona C, Mostazo Torres J (January 2016). "New approaches in the treatment of hepatitis C". World Journal of Gastroenterology. 22 (4): 1421–32. doi:10.3748/wjg.v22.i4.1421. PMC 4721977. PMID 26819511.
  3. Falade-Nwulia O, Suarez-Cuervo C, Nelson DR, Fried MW, Segal JB, Sulkowski MS (May 2017). "Oral Direct-Acting Agent Therapy for Hepatitis C Virus Infection: A Systematic Review". Annals of Internal Medicine. 166 (9): 637–648. doi:10.7326/M16-2575. PMC 5486987. PMID 28319996.
  4. "Table of Surrogate Endpoints That Were the Basis of Drug Approval or Licensure". Food and Drug Administration.
  5. "SVR does not equate to a cure in HCV". healio.com.
  6. Koretz, Ronald (2015). "Is Widespread Screening for Hepatitis C Justified?". British Medical Journal.
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