Avoiding therapeutic pitfalls: The rational use of specifically targeted agents against hepatitis C infection


  • Potential conflict of interest: Dr. McGovern advises Vertex and is on the speakers' bureau of Roche. Dr. Chung is a consultant for and received grants from Roche, Schering-Plough, and Gilead. He is also a consultant for Vertex, Merck, and Pfizer.


The development of specifically targeted antiviral agents against hepatitis C is a major therapeutic advance that promises to markedly improve treatment response rates in patients with chronic infection. However, rapid emergence of drug resistance has already been described, the consequences of which are not yet understood. Although there are important differences between hepatitis C (HCV) and human immunodeficiency virus (HIV) infection, the judicious use of candidate agents against HCV should be guided by principles that have been established in the HIV therapeutic arena. In this review, we attempt to draw useful parallels between the development of antiretroviral therapy for HIV and preliminary data on antiviral agents for hepatitis C virus infection. Applying concepts learned in HIV therapeutics will hopefully lead to a prudent and cautious path in HCV treatment paradigms, particularly with respect to drug resistance. (HEPATOLOGY 2008;48:1700–1712.)