The way forward in HCV treatment — finding the right path

Hepatitis C virus (HCV) represents an important global healthcare burden. At least 3% of the world's population is chronically infected and consequently at risk of developing liver cirrhosis and/or hepatocellular carcinoma.Morbidity and mortality rates associated with HCV are predicted to rise in the coming years, creating an urgent need for more efficacious and tolerable therapies. This is particularly important for those patients who are refractory to the current standard of care, pegylated IFN-α and ribavirin.To date, no prophylactic vaccine is available. Attempts to develop peptide-based therapeutic vaccines have been undertaken with various rates of success.Increased understanding of the HCV lifecycle has led to the identification of novel therapeutic targets. A number of innovative agents are in development, most notably protease and polymerase inhibitors.The rapid mutation rate of HCV increases the likelihood of the emergence of viruses with reduced sensitivity to therapy, necessitating the development of treatment strategies that minimize the development of resistance.Development of combination therapy strategies using agents with different modes of action has the potential to improve treatment success rates while minimizing the emergence of resistant viruses.