Metabolism of Direct-acting Antiviral Agents (DAAs) in Hepatitis C Therapy: A Review of the Literature
| Autor: | Bozena Delija, Delfa Radić-Krišto, Maja Mijić, Tajana Filipec Kanizaj, Sanja S. Shapeski, Lucija Virovic-Jukic, Ivana Mikolašević, Miloš Lalovac, Zeljko Puljiz, Dorotea Bozic, Petra Puz, Ivan Bogadi, Toni Juric |
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| Rok vydání: | 2021 |
| Předmět: |
drug-drug interactions
Cirrhosis Viral Protease Inhibitors medicine.medical_treatment Clinical Biochemistry Hepacivirus Viral Nonstructural Proteins Liver transplantation Bioinformatics Chronic liver disease chemistry.chemical_compound Liver disease Pegylated interferon Secondary Prevention medicine Humans Drug Interactions BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine direct-acting antivirals BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina Pharmacology Viral Proteases business.industry cirrhosis Ribavirin liver transplantation hepatocellular carcinoma Hepatitis C Hepatitis C Chronic RNA-Dependent RNA Polymerase medicine.disease Treatment Outcome chemistry Viral replication complex Drug Therapy Combination business medicine.drug |
| Zdroj: | Current Drug Metabolism Volume 22 Issue 2 |
| ISSN: | 1389-2002 |
| DOI: | 10.2174/1389200221999201214224126 |
| Popis: | Background:: Hepatitis C virus (HCV) infection is still one of the leading causes of chronic liver disease, with chronically infected making up approximately 1% of the global population. Of those infected, 70% (55-85%) will develop chronic HCV infection. Chronic HCV infection causes substantial morbidity and mortality, with complications including cirrhosis, end-stage liver disease, hepatocellular carcinoma, and eventually death. Objective:: Therapeutic options for chronic HCV infection have evolved dramatically since 2014, with a translation from pegylated interferon and ribavirin (associated with suboptimal cure and high treatment-related toxicity) to oral direct-acting antiviral treatment. There are four classes of direct-acting antivirals which differ by their mechanism of action and therapeutic target. They are all pointed to proteins that form the cytoplasmic viral replication complex. Multiple studies have demonstrated that direct-acting antiviral therapy is extremely well tolerated, highly efficacious, with few side effects. Methods:: We performed an indexed MEDLINE search with keywords regarding specific direct-acting antiviral regimes and their pharmacokinetics, drug-drug interactions, and metabolism in specific settings of pregnancy, lactation, liver cirrhosis, liver transplantation and HCC risk, kidney failure and kidney transplantation. Results:: We present a comprehensive overview of specific direct-acting antiviral metabolism and drug-drug interaction issues in different settings. Conclusion:: Despite its complex pharmacokinetics and the possibility of drug-drug interactions, direct-acting antivirals are highly efficacious in providing viral clearance, which is an obvious advantage compared to possible interactions or side effects. They should be administered cautiously in patients with other comorbidities, and with tight control of immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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