Grazoprevir and elbasvir: a second-generation protease inhibitor and a second-generation NS5A inhibitor in a combination regimen for treatment of chronic hepatitis C

The emergence of direct acting antivirals against HCV infection has provided the opportunity for interferon free, all oral treatments for HCV infection in patients with HCV genotype 1 (GT1). This review describes the current data on the combination of grazoprevir and elbasvir, a second-generation NS3/4A inhibitor and a second-generation NS5A inhibitor, respectively. The regimen has shown promising results in Phase II trials in patients with GT1 with response rates >90%, even in patient groups that have been challenging to treat, such as patients with cirrhosis, HIV co-infection and previous null responders to treatment with pegylated IFN- + ribavirin. Grazoprevir + elbasvir treatment is well tolerated. Phase III trials and trials including infections with GT2-4 + 6 are ongoing.