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T. Jake Liang, M.D., and Marc G. Ghany, M.D., M.H.Sc.
May 4, 2014DOI: 10.1056/NEJMe1403619
A book on hepatitis C would read like a marriage of an Orson Welles mystery and a Shakespearean play — awash in enigma, tragedy, despair, resilience, redemption, and triumph. It is only fitting that treatment of hepatitis C virus (HCV) infection stands at center stage of such a book. After the initial introduction of interferon alfa as the mainstay of therapy, the field stalled for more than 10 years. Although the introduction of ribavirin combination therapy and pegylated interferons had increased response rates, the real breakthrough came with the development of direct-acting antiviral agents (DAAs).1 The first generation of DAAs in combination with peginterferon and ribavirin showed improved response rates, but they were accompanied by worsening side effects that have precluded a great majority of patients from benefiting from therapy./.../