PK/PD and antiviral activity of anti-HCV therapy: is there still a role in the choice of treatment?

Introduction: Despite the high rate of response, the treatment of special populations, the management of patients with previous failure to direct-acting antiviral (DAA) regimens, and the development of drug resistance are still a challenge. Moreover, the FDA suggested stopping research on new DAA because of the high efficacy of those already available. Areas covered: Understanding pharmacokinetic/pharmacodynamic parameters could be a simple and effective way to improve the management of anti-hepatitis C virus (HCV) treatment. The aim of this review is to provide an overview of this aspect in order to offer a new insight into treatment choice. Expert opinion: Clinicians should offer an adequate strategy for HCV treatment taking into consideration patient-related factors and by improving their knowledge of the antiviral activity and pharmaceutical ‘forgiveness’ of each DAA.