Ribavirin revisited in the era of direct‐acting antiviral therapy for hepatitis C virus infection
Open Access
- 29 September 2016
- journal article
- review article
- Published by Wiley in Liver International
- Vol. 37 (1), 5-18
- https://doi.org/10.1111/liv.13212
Abstract
Over the past two decades, ribavirin has been an integral component of treatment for hepatitis C virus (HCV) infection, where it has been shown to improve the efficacy of (pegylated) interferon. However, because of treatment-limiting side effects and its additive toxicity with interferon, the search for interferon- and ribavirin-free regimens has been underway. The recent approvals of all-oral direct acting antivirals (DAAs) have revolutionized the HCV therapeutic landscape, and initially it was expected that the role of ribavirin with DAA regimens would be eliminated. On the contrary, what we have witnessed is that ribavirin retains an important role in the optimal treatment of some subgroups of patients, particularly those that historically have been considered the most difficult to cure. Fortunately, it has also been recognized that the safety profile of ribavirin is improved when co-administered with all-oral DAA combinations in the absence of interferon. Despite the antiviral mechanism of action of ribavirin being poorly understood, we now have a range of novel insights into the potential role of ribavirin in all-oral DAA HCV treatment and greater insight into the antiviral mechanism by which it continues to provide clinical benefit for defined patient groups.This publication has 74 references indexed in Scilit:
- Boceprevir for Previously Treated Chronic HCV Genotype 1 InfectionThe New England Journal of Medicine, 2011
- Mechanism of action of interferon and ribavirin in treatment of hepatitis CNature, 2005
- Modelling how ribavirin improves interferon response rates in hepatitis C virus infectionNature, 2004
- Effects of antiviral therapy on the cellular immune response in acute hepatitis CJournal of Hepatology, 2004
- Mechanism of action of ribavirin in the combination treatment of chronic HCV infectionJournal of Hepatology, 2002
- Hepatitis C Virus RNA-dependent RNA Polymerase (NS5B) as a Mediator of the Antiviral Activity of RibavirinOnline Journal of Public Health Informatics, 2001
- Ribavirin Induces Error-Prone Replication of GB Virus B in Primary Tamarin HepatocytesJournal of Virology, 2001
- Interferon Alfa-2b Alone or in Combination with Ribavirin as Initial Treatment for Chronic Hepatitis CThe New England Journal of Medicine, 1998
- Ribavirin treatment for patients with chronic hepatitis C: results of a placebo-controlled studyJournal of Hepatology, 1996
- Ribavirin in the treatment of chronic hepatitis C unresponsive to alfa interferonJournal of Hepatology, 1993