engleski

Pharmacogenomic testing in the era of patient tailored HCV treatment.

Treatment of HCV infection has been chalenging for decades. Numerous clinical factors, such as virus genotype, severity of symptoms, condition of the liver and pharmacogenomics, influence response to treatment. Until recently, combination therapy of pegylated interferon-a (PegIFN) and ribavirin (RBV) was the standard of care. This treatment option resulted with inadequate treatment response rates and high adverse drug reaction (ADR) rates. In the late 2000s, direct-acting antiviral agents (DAAs) were approved for use in combination therapy. During the last decade, DAAs proved to be very effective therapy option for HCV infection, with high sustained viral response rates (SVR) and imrpoved treatment safety. However, drug pricing, screening, disease assessment and public healthprioritization represent the biggest issue associated with DAAs treatment accessibility. Consequently, use of pharmacogenomic testing in clinical setting, although it has been doubtful in IFN-free DAA era, could play an important role in concept of "resource-guided therapy", where PegIFN / RBV might be applied for easy-to-treat interferon-eligible patients in resource-constrained areas. The association between pharmacogenomics and HCV therapy, along with the use of DAAs in the treatment of HCV infection will be discussed.

antiviral therapy ; treatment response ; pharmacogenomic testing

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