New Therapeutic Agent for Chronic Hepatitis C: Direct Acting Agent

Hee Bok Chae

doi:10.4166/kjg.2015.66.1.5

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Chae: New Therapeutic Agent for Chronic Hepatitis C: Direct Acting Agent

Review Article

Korean J Gastroenterol 2015;66(1):5-9.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.66.1.5

New Therapeutic Agent for Chronic Hepatitis C: Direct Acting Agent

Hee Bok Chae

Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Korea

Correspondence to: Hee Bok Chae, Department of Internal Medicine, Chungbuk National University Hospital, 776 1sunhwan-ro, Seowon-gu, Cheongju 362-711, Korea. Tel: +82-43-269-6363, Fax: +82-43-273-3252, E-mail: hbchae@chungbuk.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peginterferon and ribavirin has been the standard therapy of chronic hepatitis C for the past 15 years in Korea. However, the treatment paradigm is changing. Direct acting agents (DAAs) are oral pills that can be easily taken. In addition, DAAs are more effective and have less adverse reactions compared to the previously used drugs. Chronic hepatitis C is hard to treat because the virus is error-prone virus. Host immunity is helpless against the hepatitis C virus since it evades the host immunity through various complex mechanisms. There are 6 genotypes. Quasispecies can co-exist even in the same patients. The treatment strategy is based on the combination of the individual drug corresponding to each step of viral replication process. NS5B nucleosides are the most powerful and effective drug available until now. Other drugs with different mechanisms of action can be used to provide synergy. NS5A and NS5B inhibition drugs currently belong to the leading group amongst many DAAs. These drugs will soon be available in Korea. We have to know the merits and adverse drug reactions of the new drug

Keywords: Hepatitis C, chronic, Therapeutics

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Fig. 1.

Direct acting agents and corresponding sites of HCV gene. Modified from the article of Chae et al.¹² (ScientificWorldJournal 2013. doi: 10.1155/2013/704912).

Fig. 2.

Targets for direct acting agent. Adapted from the article of Racanelli and Rehermann¹³ (Trends Immunol 2003;24:456–464) with the permission of original copyright holder. LDL, low density lipoprotein; VLDL, very low density lipoprotein; ER, endoplasmic reticulum; NS3/4A, protease; NS5A, replication complex; NS5B, RNA dependent RNA polymerase.

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