Treatment of Hepatitis C with First Generation Protease Inhibitors

The treatment of hepatitis C has advanced considerably in recent decades. The discovery of Protease Inhibitors (PIs), the first Direct Acting Antivirals (DAAs), was promising as these drugs were able to dramatically decrease the Viral Load (VL). In 2011, the first generation of DAAs, Telaprevir (TVR) and Boceprevir (BOC), was released for use against infection with Hepatitis C Virus (HCV) genotype 1, and triple therapy was subsequently considered the standard therapy. In Brazil, the Ministry of Health began to provide these drugs in 2012 for patients with advanced fibrosis (F3 and F4) and/or for patients not responding to previous treatment.

The proposed treatment includes the elimination of the virus and a decrease in the progression of liver disease. The inclusion of PIs in association with Pegylated Interferon (PEG-IFN) and Ribavirin (RBV) increased the Sustained Virologic Response (SVR) rate, defined as the absence of detectable viral RNA in serum 3–6 months after the end of therapy; SVR is the best indicator of effective treatment.