| Hepatitis C virus (HCV) infection is the leading cause of hepatic decompensation, hepatocellular carcinoma and liver transplantation. In Asia region, it is reported that 49-64 million people are infected with HCV. For genotype distribution, HCV genotype 1 (HCV-1) predominates in Asia, and the distribution of HCV genotype non-1 varies across different regions. In patients who achieve sustained virologic response (SVR) following antiviral therapies for HCV, the long-term morbidity and mortality would decrease, regardless of the stage of hepatic fibrosis. In the era of peginterferon plus ribavirin, the SVR rates in Asian HCV-1 patients are superior to Western patients due to higher rates of favorable interleukin-28B genotype. The response rates between Asian and Western patients are comparable in HCV genotype non-1 infection. Although the response rates are well, they are far from ideal and these patients should need lengthy treatment and may have high rates of adverse events. In the era of interferon (IFN) -free direct acting antiviral agents (DAAs), the SVR rates are excellent by various treatment regimens. The safety profiles are also excellent. However, the current DAA regimens are type/subtype specific, more potent pan-genotypic regimens, with shorter treatment duration, lower pill burdens, fewer drug-drug interactions, and effective to prior IFN-free DAA failure are awaited in the near future. Furthermore, improving patient awareness and access to treatment are also needed to decrease the gap of treatment. |
