Abstract
After the discovery of the hepatitis B virus in 1968 and of the hepatitis A virus in 1973, many years were needed to identify the hepatitis C virus (HCV) in 1989. The discovery of HCV was a revolution for hepatology because of the magnitude of the global burden related to HCV infection, a major cause of cirrhosis and hepatocellular carcinoma. Therapy of hepatitis C has rapidly evolved with currently nearly 60% of sustained virological response with the combination of pegylated interferon plus ribavirin. In patients with sustained virological response, viral eradication, corresponding to the cure of infection, and regression of histological liver lesions have been demonstrated. Recently, the availability of in vitro culture systems allowed to characterize viral enzymes, potential therapeutic targets. A novel therapeutic era is open with the protease and polymerase inhibitors, used as a first step in association with pegylated interferon and ribavirin, both to increase efficacy and decrease the risk of resistance. Thanks to these new molecules with a potent antiviral activity, one can reasonably predict a rapid improvement of treatments becoming more efficient and also better tolerated with the progressive replacement of interferon and ribavirin by combinations of these virus specific enzyme inhibitors.
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