Summary
Around 70 to 100 million people are chronically infected with HCV worldwide. HCV antiviral
drug development has revolutionised the treatment of HCV, with several direct-acting
antiviral agents offering patients the chance of cure after only 8–12 weeks of treatment.
Drug development was initially focussed on HCV genotype 1 (GT1) infection, since this
was the most prevalent worldwide, although clinical trials included all genotypes
prevalent in the US and Europe. Because the earliest in vitro assays utilised the GT1b and 2 replicons, the initial classes of direct-acting antivirals
(protease inhibitors, non-nucleotide polymerase inhibitors) were GT1-specific, albeit
they had an effect on other less prevalent genotypes. Epidemiological data has shown
the regional importance of other HCV genotypes. More than 50% of all HCV infections
around the globe are not with GT1. The prevalence of HCV genotype 4 (GT4), 5 (GT5),
and 6 (GT6) is increasing in North America and Europe due to migration from the Middle
East, Africa and South-East Asia. With the successful development of the multi and
pan-genotypic non-structural protein 5A inhibitors, second generation protease inhibitors
and nucleotide non-structural protein 5B inhibitors comes a unique opportunity to
achieve global HCV elimination. The goal of this review is to summarise the available
information pertaining to GT4, GT5 and GT6, with a specific focus on direct-acting
antiviral agents.
Keywords
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Article info
Publication history
Published online: December 08, 2017
Accepted:
November 13,
2017
Received in revised form:
November 1,
2017
Received:
August 9,
2017
Identification
Copyright
© 2017 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver.
