Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Future therapies for hepatitis C: where do we go from here?

Nature Clinical Practice Gastroenterology & Hepatology volume 4, pages 60–61 (2007)Cite this article

Chronic hepatitis C affects over three million people in the US, is associated with the development of cirrhosis and hepatocellular carcinoma, and represents the most common indication for liver transplantation. Although treatment has improved, nearly 50% of patients fail to achieve a sustained virologic response (SVR). Nonresponse to treatment is particularly prevalent in patients infected with HCV genotype 1 (the predominant HCV genotype in the US), those with cirrhosis or with HIV coinfection, and African Americans.

Research in HCV therapy focuses on refining existing drugs and on developing compounds with novel mechanisms of action. Taribavirin (Valeant, Costa Mesa, CA) is a prodrug that is converted to ribavirin and concentrated in the liver. In two phase III trials that compared treatment with either pegylated interferon (PEG-IFN)-α2b, or PEG-IFN-α2a in combination with taribavirin versus ribavirin alone, taribavirin failed to meet noninferiority criteria for efficacy although superior hematologic safety was demonstrated.1 (See supplementary information for the full list of abstracts). Further studies with taribavirin dosage based on body weight are expected. Eltrombopag (GlaxoSmithKline, Middlesex, UK) is a novel small molecule that functions as a potent thrombopoietin. A phase II study has shown eltrombopag to raise platelet counts effectively to levels >200 × 109/l which enables the use of standard HCV therapy in 71–91% of patients.2 The capacity to treat patients with cirrhosis and HCV might, therefore, be facilitated by the use of this agent in conjunction with interferon-based therapy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Colombo M (Ed.; 2006) Abstracts of the 41st Annual Meeting of the European Association for the Study of the Liver: 2006 April 26–30; Vienna. J Hepatol 44 (Suppl 2): S3–S278

    Google Scholar 

  2. Blei AT (Ed.; 2006) Abstracts of the 57th annual meeting of the American Association for the Study of Liver Diseases (57th AASLD): 2006 October 27–31; Boston. Hepatology 44 (Suppl 1): S1–S258

    Article  Google Scholar 

  3. Reesink HW et al. (2006) Rapid decline of viral RNA in hepatitis C patients treated with VX-950: a phase Ib, placebo-controlled, randomized study. Gastroenterology 131: 997–1002

    Article  CAS  Google Scholar 

  4. Blei AT (Ed.; 2005) Abstracts of the 56th annual meeting of the American Association for the Study of Liver Diseases (56th AASLD): 2005 November 11–15; San Francisco. Hepatology 42 (Suppl 1): S1–S257

    Article  Google Scholar 

  5. Digestive Disease Week, May 21–24, 2006, Los Angeles, CA. Gastroenterology 130 (Suppl 2)

  6. Tong X et al. (2006) Identification and analysis of fitness of resistance mutations against the HCV protease inhibitor SCH 503034. Antiviral Res 70: 28–38

    Article  CAS  Google Scholar 

  7. Paeshuyse J et al. (2006) The non-immunosuppressive cyclosporin DEBIO-025 is a potent inhibitor of hepatitis C virus replication in vitro. Hepatology 43: 761–770

    Article  CAS  Google Scholar 

  8. Whitby K et al. (2004) Action of celgosivir (6 O-butanoyl castanospermine) against the pestivirus BVDV: implications for the treatment of hepatitis C. Antivir Chem Chemother 15: 141–151

    Article  CAS  Google Scholar 

  9. Dugourd D et al. (2006) Investigation of the synergistic interactions of the alpha-glucosidase I inhibitor celgosivir with various interferons. Presented at the 13th International Meeting on Hepatitis C Virus & Related Viruses: 2006 August 27–31, Cairns, Australia.

  10. Nevens F et al. (2003) A pilot study of therapeutic vaccination with envelope protein E1 in 35 patients with chronic hepatitis C. Hepatology 38: 1289–1296

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. and I Jacobson is the Chief of the Division of Gastroenterology and Hepatology and the Medical Director of the Center for the Study of Hepatitis, S Sigal is an Assistant Professor of Medicine, at the Weill Medical College of Cornell University, New York, NY, USA.,

    Samuel Sigal & Ira Jacobson

Authors
  1. Samuel Sigal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ira Jacobson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ira Jacobson.

Ethics declarations

Competing interests

I Jacobson declared he has associations with the following companies: Bristol-Myers Squibb, Celera, Coley, Gilead, GlaxoSmithKline, Globimmune, Human Genome Sciences, Idenix, Intarcia, Intermune, Merck, Novartis, Pfizer, Schering, TAP, Valeant, Vertex and XTL.

S Sigal declared he has associations with the following company: GlaxoSmithKline.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sigal, S., Jacobson, I. Future therapies for hepatitis C: where do we go from here?. Nat Rev Gastroenterol Hepatol 4, 60–61 (2007). https://doi.org/10.1038/ncpgasthep0736

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpgasthep0736

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing