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Two new interferon-free oral treatments, Viekirax (ombitasvir, paritaprevir and ritonavir) plus dasabuvir (Exviera), are now licensed, with or without ribavirin, for genotype 1 (GT1) chronic HCV infection.

Patients with GT1 take both Viekirax and Exviera. Viekirax is also licensed combined with ribavirin for people with GT4 chronic HCV who have not developed cirrhosis. About 214,000 people in the UK live with HCV, with GT1 accounting for 45-48 per cent of these infections. However Viekirax and Exviera are not indicated for GT3, which accounts for about another 45 per cent of cases.

Manufacturer AbbVie says that Viekirax plus dasabuvir is the first treatment for chronic HCV “to combine three directacting antiviral agents with distinct mechanisms of action”. Ritonavir blocks CYP3A4 to boost levels of paritaprevir. Viekirax plus dasabuvir, with or without ribavirin for 12 or 24 weeks, cleared the virus in 97 per cent of GT1 patients, says AbbVie.

Viekirax plus ribavirin cleared 100 per cent of GT4 patients without cirrhosis. Just 0.2 per cent of patients discontinued due to adverse reactions and no-one receiving Viekirax plus dasabuvir without ribavirin discontinued because of side-effects.