Hepatitis C: The Story of a Long Journey through First, Second, and Third Generation NS3/4A Peptidomimetic Inhibitors. What Did We Learn?

J Med Chem. 2024 Jan 25;67(2):885-921. doi: 10.1021/acs.jmedchem.3c01971. Epub 2024 Jan 5.

Abstract

Hepatitis C viral (HCV) infection is the leading cause of liver failure and still represents a global health burden. Over the past decade, great advancements made HCV curable, and sustained viral remission significantly improved to more than 98%. Historical treatment with pegylated interferon alpha and ribavirin has been displaced by combinations of direct-acting antivirals. These regimens include drugs targeting different stages of the HCV life cycle. However, the emergence of viral resistance remains a big concern. The design of peptidomimetic inhibitors (PIs) able to fit and fill the conserved substrate envelope region within the active site helped avoid contact with the vulnerable sites of the most common resistance-associated substitutions Arg155, Ala156, and Asp168. Herein, we give an overview of HCV NS3 PIs discovered during the past decade, and we deeply discuss the rationale behind the structural optimization efforts essential to achieve pangenotypic activity.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / chemistry
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Drug Resistance, Viral
  • Hepacivirus
  • Hepatitis C* / drug therapy
  • Hepatitis C, Chronic* / drug therapy
  • Humans
  • Peptidomimetics* / pharmacology
  • Peptidomimetics* / therapeutic use
  • Protease Inhibitors / pharmacology
  • Viral Nonstructural Proteins

Substances

  • Antiviral Agents
  • Peptidomimetics
  • Protease Inhibitors
  • Viral Nonstructural Proteins