Pangenotypic treatment regimens for chronic hepatitis C

Authors: Petr Urbánek
Authors‘ workplace: Interní klinika 1. LF UK a ÚVN – Vojenská fakultní nemocnice Praha
Published in: Vnitř Lék 2019; 65(9): 553-563


The treatment of chronic hepatitis C is currently based exclusively on the use of drugs from the direct-acting anti­viral class. They are substances that inhibit one of the 3 most important enzymes of the virus replication cycle. Anti­viral drugs are divided according to the target structure into 3 basic classes, further division is mainly based on the chemical structure of individual antivirals. A common feature of all the regimens is high efficiency and safety. Pangenotypic efficacy regimens are those that utilize a combination of 2 or 3 antiviral agents of different classes, and are effective for all HCV genotypes. Currently there are 3 such regimens available. Pangenotypic regimens probably represent the latest stage of development of treatment for chronic hepatitis C. The review discusses in detail the efficiency of different pangenotypic regimens in individual subgroups of patients with HCV infection. Atten­tion is primarily paid to the data bases for their use.


antiviral agent – treatment

  1. [World Health organization]. Global alert and response (GAR). Hepatitis C. 2012. Dostupné z WWW: <>.
  2. Perz JF, Armstrong GL, Farrington LA et al. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45(4): 529–538. Dostupné z DOI: <>.
  3. Kanwal F, Hoang T, Kramer JR et al. Increasing prevalence of HCC and cirrhosis in patients with chronic hepatitis C virus infection. Gastroenterology 2011; 140(4): 1182–1188.e1. Dostupné z DOI: <>.
  4. Deuffic-Burban S, Poynard T, Sulkowski MS et al. Estimating the future health burden of chronic hepatitis C and human immunodeficiency virus infections in the United States. J Viral Hepat 2007; 14(2): 107–115. Dostupné z DOI: <–2893.2006.00785.x>.
  5. Urbánek P, Husa P, Galský J et al. Standardní diagnostický a terapeutický postup chronické infekce virem hepatitidy C (HCV). Čas Lék. Česk 2008; 147(5): 1–12.
  6. Fried MW, Shiffman ML, Reddy KR et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002; 347(13): 975–982. Dostupné z DOI: <>.
  7. Hadziyannis SJ, Sette H, Morgan TR et al. Peginterferon-alfa2a and ribavirin combination therapy in chronic hepatitis C. Ann Intern Med 2004; 140(5): 346–355. Dostupné z DOI: <–4819–140–5-200403020–00010>.
  8. European Association for the Study of the Liver. EASL Recommendations on Treatment of Hepatitis C 2018. J Hepatol 2018; 69(2): 461–511. Dostupné z DOI: <>.
  9. Epclusa. SPC. Datum první registrace: 6. července 2016, datum poslední revize textu: červenec 2016. Dostupné z WWW: <>.
  10. Younossi ZM, Stepanova M, Feld J et al. Sofosbuvir/velpatasvir improves patient-reported outcomes in HCV patients: Results from ASTRAL-1 placebo-controlled trial. J Hepatol 2016; 65(1): 33–39. Dostupné z DOI: <>.
  11. Younossi ZM, Stepanova M, Sulkowski M et al. Ribavirin-Free Regimen With Sofosbuvir and Velpatasvir Is Associated With High Efficacy and Improvement of Patient-Reported Outcomes in Patients With Genotypes 2 and 3 Chronic Hepatitis C: Results from Astral-2 and -3 Clinical Trials. Clin Infect Dis 2016; 63(8): 1042–1048. Dostupné z DOI: <>.
  12. Foster GR, Afdhal N, Roberts SK et al. Sofosbuvir and Velpatasvir for HCV Genotype 2 and 3 Infection. N Engl J Med 2015; 373(27): 2608–2617. Dostupné z DOI: <>.
  13. Curry MP, O’Leary JG, Bzowej N et al. Sofosbuvir and Velpatasvir for HCV in Patients with Decompensated Cirrhosis. N Engl J Med 2015; 373(27): 2618–2628. <>.
  14. Maviret. SPC. Datum první registrace: 26. 7. 2017, datum poslední revize textu: listopad 2018. Dostupné z WWW: <>.
  15. Zeuzem S, Foster GR, Wang S et al. Glecaprevir-Pibrentasvir for 8 or 12 Weeks in HCV Genotype 1 or 3 Infection. N Engl J Med 2018; 378(4): 354–369. Dostupné z DOI: <>.
  16. Asselah T, Kowdley KV, Zadeikis N et al. Efficacy of Glecaprevir/Pibrentasvir for 8 or 12 Weeks in Patients With Hepatitis C Virus Genotype 2, 4, 5, or 6 Infection Without Cirrhosis. Clin Gastroenterol Hepatol 2018; 16(3): 417–426. Dostupné z DOI: <>.
  17. Forns X, Lee SS, Valdes J et al. Glecaprevir plus pibrentasvir for chronic hepatitis C virus genotype 1, 2, 4, 5, or 6 infection in adults with compensated cirrhosis (EXPEDITION-1): a single-arm, open-label, multicentre phase 3 trial. Lancet Infect Dis 201; 17(10): 1062–1068. Dostupné z DOI: <–3099(17)30496–6>.
  18. Brown RS Jr, Hezode C, Wang S et al. Preliminary efficacy and safety of 8-week glecaprevir/pibrentasvir in patients with HCV genotype 1–6 infection and compensated cirrhosis: the EXPEDITION-8 study [AASLD abstract LB-7]. Hepatology 2018; 68(Suppl 1). Dostupné z WWW: <>.
  19. Wyles D, Poordad F, Wang S et al. Glecaprevir/pibrentasvir for hepatitis C virus genotype 3 patients with cirrhosis and/or prior treatment experience: A partially randomized phase 3 clinical trial. Hepatology 2017; 67(2):514–523. Dostupné z DOI: <>.
  20. Kwo PY, Poordad F, Asatryan A et al. Glecaprevir and pibrentasvir yield high response rates in patients with HCV genotype 1–6 without cirrhosis. J Hepatol 2017; 67(2): 263–271. Dostupné z DOI: <>.
  21. Vosevi. SPC. Datum první registrace: 26. července 2017, datum poslední revize textu: listopad 2018. Dostupné z WWW: <>.
  22. Bourlière M, Gordon SC, Flamm SL et al. Sofosbuvir, Velpatasvir, and Voxilaprevir for Previously Treated HCV Infection. N Engl J Med 2017; 376(22): 2134–2146. Dostupné z DOI: <http://10.1056/NEJMoa1613512>.
  23. Jacobson IM, Lawitz E, Gane EJ et al. Efficacy of 8 Weeks of Sofosbuvir, Velpatasvir, and Voxilaprevir in Patients With Chronic HCV Infection: 2 Phase 3 Randomized Trials. Gastroenterology 2017; 153(1): 113–122. Dostupné z DOI: <>.
  24. Foster GR, Thompson A, Ruane PJ et al. A Randomized, Phase 3 Trial of Sofosbuvir/Velpatasvir/Voxilaprevir for 8 Weeks and Sofosbuvir/Velpatasvir for 12 Weeks for Patients with Genotype 3 HCV Infection and Cirrhosis: The POLARIS-3 Study. Hepatology 2016; 64(1 Suppl): A258. Dostupné z DOI: <>.
  25. Zeuzem S, Flamm S, Tong M et al. A Randomized, Controlled, Phase 3 Trial of Sofosbuvir/Velpatasvir/Voxilaprevir or Sofosbuvir/Velpatasvir for 12 Weeks in Direct-Acting Antiviral-Experienced Patients With Genotype 1–6 HCV Infection: The POLARIS-4 Study. Hepatology 2016; 64(1 Suppl): A109. Dostupné z DOI: <>.
Diabetology Endocrinology Internal medicine
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account