Optimal management of HCV Genotype 3

It is estimated that 10–15 % of the 185 million patients suffering from hepatitis C virus are infected by genotype 3. Both genotypes 2 and 3 were considered to be the easy-to-treat genotypes. However, due to some special features, such as its relationship with the development of steatosis, more rapid progression to hepatic fibrosis, and particularly its lower sensitivity to interferon, genotype 3 has become one of the most difficult groups to treat. The emergence of new direct-acting antivirals has optimized the treatment of hepatitis C virus, allowing us to shorten the duration of therapy, increasing the sustained virologic response rate, and improving the tolerance to therapy through combinations free of interferon. The development of these drugs is focused on genotype 1, the most prevalent hepatitis C virus in Western countries. However, some of them have activity against genotype 3, especially nucleotide/nucleoside polymerase inhibitors and NS5A inhibitors. The special characteristics of genotype 3 and the current and future options of treatment are reviewed herein.