Is the 25-year hepatitis C marathon coming to an end to declare victory?

Table 1 Food and Drug Administration approved anti-hepatitis C virus tests[28]

Abbott HCV EIA 2.0	Abbott Laboratories, AbbottPark, IL	EIA (Manual)
ADVIA Centaur HCV	Siemens, Malvern, PA, United States	CIA (Automated)
ARCHITECT anti-HCV	Abbott Laboratories, AbbottPark, IL	CMIA (Automated)
AxSYM anti-HCV	Abbott Laboratories, AbbottPark, IL	MEIA (Automated)
OraQuick Rapid Test	OraSure Technologies,Bethlehem,PA	Immunochromatographic (Manual)
Ortho HCV Version 3.0 EIA	Ortho	EIA (Manual)
VITROS anti-HCV	Ortho	CIA (Automated)

Anti-HCV: HCV antibody; EIA: Enzyme immunoassay; CIA: Chemiluminescent immunoassay; MEIA: Microparticle enzyme immunoassay; CMIA: Chemiluminescent microparticle immunoassay.

Table 2 Milestones in the history of hepatitis C

1975	Non-A, non-B hepatitis was first described[36,37]
1989	Randomized controlled trials were carried out using interferon alpha to treat non-A, non-B hepatitis[38-40]
1989	HCV was identified[1]
1991	Ribavirin is used as a monotherapy for chronic hepatitis C[41,42]
1995	The combination of interferon alpha and ribavirin were tested[43,44]
1996	Hepatitis C serine protease structure was published[45]
1998	First randomized double-blind, placebo controlled study using recombinant interferon alpha alone or in combination with ribavirin[46,47]
1999	Structure of hepatitis C RNA-dependent RNA polymerase NS5B was identified[48,49]
2001	Pegylated interferon alpha and ribavirin were used in trials[50,51]
2005	Structure of NS5A was published[52]
2011	First direct acting agents: Protease inhibitors were used in combination with pegylated interferon and ribavirin to treat hepatitis C genotype 1[53,54]
2012	Pilot studies using combinations of direct-acting antiviral drugs without interferon[55]
2014	Several direct acting antiviral medications were released to the market to treat different hepatitis C genotypes with SVR exceeding 90% and with better tolerability

HCV: Hepatitis C virus; SVR: Sustained virologic response.

Table 3 American Association for the Study of Liver Diseases/Infectious Diseases Society of America Guideline Recommendations: Genotypes 1, 2, 3, 4, 5 and 6 hepatitis C virus[58]

HCV genotype	Cirrhosis	Prior Tx	Recommended regimen	Alternative regimen	Notes
1a	No		LDV/SOF 12 wk
			DCV + SOF 12 wk
			SMV + SOF 12 wk
			SOF/VEL 12 wk
			GZR/EBR 12 wk		NS5A RAVs absent
				GZR/EBR 16 wk + RBV	NS5A RAVs present
			OBV/PTV/RTV + DSV 12 wk + RBV
1b	No		LDV/SOF 12 wk
			DCV + SOF 12 wk
			SMV + SOF 12 wk
			SOF/VEL 12 wk
			GZR/EBR 12 wk
			OBV/PTV/RTV + DSV 12 wk
1a	Compensated	Naive	LDV/SOF 12 wk
				DCV + SOF 24 wk ± RBV
				SMV + SOF 24 wk ± RBV	No Q80K
			SOF/VEL 12 wk
			GZR/EBR 12 wk		NS5A RAVs absent
				GZR/EBR 16 wk + RBV	NS5A RAVs present
				OBV/PTV/RTV + DSV 24 wk +RBV
1a	Compensated	PR exp	LDV/SOF 12 wk + RBV or 24 wk
				DCV + SOF 24 wk ± RBV
				SMV + SOF 24 wk ± RBV	No Q80K
			SOF/VEL 12 wk
			GZR/EBR 12 wk		NS5A RAVs absent
				GZR/EBR 16 wk + RBV	NS5A RAVs present
				OBV/PTV/RTV + DSV 24 wk + RBV
1b	Compensated	Naive	LDV/SOF 12 wk
				DCV + SOF 24 wk ± RBV
				SMV + SOF 24 wk ± RBV
			SOF/VEL 12 wk
			GZR/EBR 12 wk
			OBV/PTV/RTV + DSV 12 wk
1b	Compensated	PR exp	LDV/SOF 12 wk + RBV or 24 wk
				DCV + SOF 24 wk ± RBV
				SMV + SOF 24 wk ±- RBV
			SOF/VEL 12 wk
			GZR/EBR 12 wk
			OBV/PTV/RTV + DSV 12 wk
1a or 1b	Decompensated	Naive or exp	SOF/VEL 12 wk + RBV		Child-Pugh
					B or C
2	No	Naive	SOF/VEL 12 wk
				SOF + DCV 12 wk
2	No	PR exp	SOF/VEL 12 wk
				SOF + DCV 12 wk
2	No	SR exp	DCV + SOF 24 wk ± RBV
			SOF/VEL 12 wk + RBV
2	Compensated	Naive	SOF/VEL 12 wk
				SOF + DCV 16-24 wk
2	Compensated	PR exp	SOF/VEL 12 wk
				SOF + DCV 16-24 wk
2	Compensated	SR exp	DCV + SOF 24 wk ± RBV
			SOF/VEL 12 wk + RBV
2	Decompensated	Naive or exp	SOF/VEL 12 wk + WB RBV		Child-Pugh B or C
			DCV + SOF 12 wk + low initial dose RBV		Child-Pugh B or C
3	No	Naive	SOF + DCV 12 wk
			SOF/VEL 12 wk
3	No	PR exp	SOF + DCV 12 wk
			SOF/VEL 12 wk
3	No	SR exp	DCV + SOF 24 wk + RBV
			SOF/VEL 12 wk + RBV
3	Compensated	Naive	SOF/VEL 12 wk
			SOF + DCV 24 wk ± RBV
3	Compensated	PR exp	SOF/VEL 12 wk + RBV
			SOF + DCV 24 wk + RBV
3	Compensated	SR exp	SOF + DCV 24 wk + RBV
			SOF/VEL 12 wk + RBV
3	Decompensated	Naive or exp	SOF/VEL 12 wk + WB RBV		Child-Pugh B or C
			DCV+ SOF 12 wk + low initial dose RBV		Child-Pugh B or C
4	No cirrhosis or compensated	Naive	SOF/LDV 12 wk
			OBV/PTV/RTV 12 wk + RBV
			GRZ/EBV 12 wk
			SOF/VEL 12 wk
4	No	PR exp	SOF/LDV 12 wk
			OBV/PTV/RTV 12 wk + RBV
			GRZ/EBV 12 wk		Relapse
			GRZ/EBV 16 wk + RBV		Others
			SOF/VEL 12 wk
4	Compensated	PR exp	SOF/LDV 12 wk + RBV	SOF/LDV 24 wk
			OBV/PTV/RTV 12 wk + RBV
			GRZ/EBV 12 wk		Relapse
			GRZ/EBV 16 wk + RBV		Others
			SOF/VEL 12 wk
5 or 6	No cirrhosis or compensated	Naive or PR exp	SOF/LDV 12 wk
			SOF/VEL 12 wk

AASLD: American Association for the Study of Liver Diseases; DCV: Daclatasvir; DSV: Dasabuvir; EBR: Elbasvir; GT: Genotype; GZR: Grazoprevir; LDV: Ledipasvir; OBV: Ombitasvir; PR: Peginterferon/ribavirin; PTV: Paritaprevir; RAV: Resistance associated variant; RBV: Ribavirin; RTV: Ritonavir; SMV: Simeprevir; SOF: Sofosbuvir; VEL: Velpatasvir; WB: Weight-based; SR: Sofosbuvir/ribavirin; exp: Experienced; Tx: Treatment.