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. 2019 Jun 17;8(6):604. doi: 10.3390/cells8060604

Table 5.

Antiviral treatments for HCV.

Drug name DAA PEG-IFNα-2A NA808 Interferon-λ Claudin-1
Trade name Many different DAA in the market with individual names Pegasys - - -
Manufacturing company A range of companies manufacture DAA Roche Pharmaceuticals - - -
Mechanism of action Disrupts HCV viral life cycle by shortening the length of therapy, minimizing size effects, targeting the virus, improving sustained virological response rates Acts as interferon within the immune system Halts HCV replication via non-competitive inhibition of Serine Palmitoyltransferase (SPT), hence reducing viral load in mice IFN-λ binds to heterodimeric IFN-λ receptor, activates STAT phosphorylation-dependent signal cascade which induces hundreds of IFN-stimulated genes, which in turn modulates a range of immune functions Blocks entry of HCV
Commonly used in combination PEG-IFNα-2A and Ribavirin DAA and Ribavirin PEG-IFNα-2A, HCV polymerase/ protease inhibitors Not fully characterized Ribavirin
Rate of SVR ~95% ~79% in genotype
1~89% in genotype 2 or 3		 Not fully characterized Not fully characterized Not fully characterized
Stage of clinical trial - Completed and in market - - -
Side effects Fatigue, gastrointestinal symptoms, anemia, headache and dyspnea Headache, fatigue, depression, insomnia, nausea, pain at site of injection, fever, psychosis, autoimmune disorders, blood clots and infection Not fully characterized
Inhibition of host enzyme might result in mechanism-related toxicities/side effects		 Not fully characterized Not fully characterized
Advantages

  • Effective

  • Wide range of DAA

  • Safe

  • Effective particularly in patients with IL28B genotype

  • No development of resistant mutants

  • Able to prevent replication of HCV genotypes 1a, 1b, 2a, 3a, and 4a

 Not fully characterized Not fully characterized
Limitations

  • Expensive

  • Unavailable in some regions of the world

  • Extensive and systemic side effects

  • Limited efficacy

  • Viral and host factors can result in non-responders

 Not fully characterized Not fully characterized Not fully characterized
References Williford et al. (2016) [3] Huang et al. (2017) [138] Katsume et al. (2013) [126] Bruening et al. (2018) [139]

  • Colpitts et al. (2018) [140]

  • Evans et al. (2017) [121]

  • Meertens et al. (2008) [136]

Abbreviations - DAA: Direct-acting antiviral, HCV: Hepatitis C virus, PEG-IFNα-2A: Pegylated-interferon-α-2A, SVR: Sustained virological response, SPT: Serine Palmitoyltransferase