New agents for the treatment of hepatitis C virus – focus on telaprevir

AJ Thompson,1–3 K Patel31Department of Gastroenterology, St Vincent's Hospital, University of Melbourne, 2Victorian Infectious Diseases Reference Laboratory, North Melbourne, Victoria, Australia; 3Duke Clinical Research Institute and Department of Gastroenterology, Duke University Medical Center, Durham, NC, USAAbstract: Antiviral therapy for hepatitis C virus (HCV) is rapidly evolving with the advent of direct-acting antiviral agents. Telaprevir is a first-generation linear ketoamide inhibitor of HCV NS3 protease. Approved in 2011 as standard-of-care for the treatment of patients chronically infected with HCV genotype 1, telaprevir represents a major therapeutic advance. Used in combination with PEGylated interferon-alfa and ribavirin, telaprevir-based regimens cured > 75% of treatment-na ve patients in the Phase III registration studies. Telaprevir is also effective for patients who have previously failed interferon-based therapy. Telaprevir presents a number of new challenges for clinicians, including a more demanding dosing schedule, telaprevir-specific adverse events, potential for drug–drug interactions, and selection of drug-resistant HCV variants.Keywords: telaprevir, HCV, NS3, protease inhibitor, resistance