Safety of direct antiviral agents in the management of hepatitis C

Expert Opin Drug Saf. 2016 Dec;15(12):1643-1652. doi: 10.1080/14740338.2017.1240781. Epub 2016 Oct 6.

Abstract

Hepatitis C virus is a hepatotropic virus that generally leads to chronic hepatitis and various harmful sequelae. The lone standard of treatment has been pegylated interferon and ribavirin, which produces a modest response and many side effects. However, a new era of management was declared with the introduction of various directly acting antiviral agents. Areas covered: Recent direct antiviral agents (DAAs) primarily target the non-structural proteins of the virus and affect its replication. These agents successfully achieve a sustained virologic response. However, some serious side effects were reported, which may or may not be drug-related effects. Important drug-drug interactions were also reported. The treating physician should be reasonably familiar with these effects. We review the safety profile of these agents in the management of HCV. Expert opinion: Cautious concomitant drug intake is necessary for the new HCV therapies. Future HCV management will depend on interferon-free and likely ribavirin-free regimens. The co-administration of direct antiviral agents of different classes increases the probability of side effects and drug-drug interactions.

Keywords: Direct antiviral agents; drug interactions; hepatitis C (HCV); safety; side effects.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiviral Agents / adverse effects
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Drug Interactions
  • Hepacivirus / drug effects*
  • Hepatitis C / drug therapy*
  • Humans
  • Virus Replication / drug effects

Substances

  • Antiviral Agents