Telaprevir and boceprevir: The future is now

The world changed in 2011 for the hepatitis C virus (HCV), with the FDA's and EMA's approval of the two new first generation protease inhibitors for the treatment of hepatitis C, boceprevir and telaprevir. Viral response rates have increased for genotype 1 patients by 2-6 fold compared to the thus far standard of care with pegylated interferon alfa plus ribavirin. Response very much depends on whether the patient is treatment naïve or whether he failed previous standard of care therapy either as relapser, partial or null responder. But not all that glitters is gold: additional side effects to SVR rates, drug-drug interactions, new contraindications and additional cost have added to the complexity of the management of hepatitis C. In this review we summarize the main features of boceprevir and telaprevir including clinical trial results and real life experience gathered since their approval.