Re- understanding of refractory hepatitis C: progress in antiviral therapy strategies for hepatitis C

It has been nearly 20 years from the discovery of hepatitis C virus ( HCV) and clinical diagnosis of hepatitis C to antiviral therapy with interferon, and significant progress has been made. Substantial changes have taken place in both the concept and strategy for antiviral treatment of hepatitis C, with more and more direct- acting antiviral agents emerging in recent years; these changes are as follows: from the control of HCV to clinical cure, from a sustained virologic response ( SVR) rate around 30% with conventional interferon therapy to an SVR rate of 70%- 80% with standard therapy with pegylated interferon and ribavirin, and from evaluating the difficulty of treatment based on genotypes and viral load to determining the treatment strategy according to host IL28B genotypes and response patterns ( rapid virologic response and complete early virologic response) . The progress in antiviral therapy strategies for hepatitis C is systematically reviewed for re-understanding of refractory hepatitis C.