Treatment of Chronic Hepatitis C: Efficacy, Side Effects and Complications.
Antiviral therapy
Complications
Hepatitis C virus
Side effects
Treatment
Journal
Visceral medicine
ISSN: 2297-4725
Titre abrégé: Visc Med
Pays: Switzerland
ID NLM: 101681546
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
27
04
2019
accepted:
14
05
2019
entrez:
2
8
2019
pubmed:
2
8
2019
medline:
2
8
2019
Statut:
ppublish
Résumé
Chronic hepatitis C virus (HCV) infection can lead to liver cirrhosis and its complications. Viral eradication is essential to prevent disease progression and reduces liver-related mortality and morbidity. Since the availability of direct-acting antivirals (DAA), HCV treatment has changed significantly. Current treatment strategies for different groups of patients as well as potential risks and caveats will be discussed in this review. Interferon-free (IFN-free) treatment not only shortens treatment duration, but also achieves high rates of viral clearance and is overall well tolerated. Genotype-restricted but also pangenotypic combinations are available. Usually two DAA of different drug classes are combined. For the majority of the patients, treatment duration ranges from 8 to 12 weeks. Liver and kidney function as well as prior treatment experience and potential drug-drug interactions influence substance choices and treatment duration. However, modern IFN-free treatment is not only safer, but also overall far more simplified and effective. Global HCV eradication might be an ambitious but not completely unrealistic goal to pursue. IFN-free antiviral treatment is safe and well tolerated. Patients can be treated almost independently of liver function or concomitant disease. Viral eradication is associated with reduced morbidity and mortality and better quality of life.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic hepatitis C virus (HCV) infection can lead to liver cirrhosis and its complications. Viral eradication is essential to prevent disease progression and reduces liver-related mortality and morbidity. Since the availability of direct-acting antivirals (DAA), HCV treatment has changed significantly. Current treatment strategies for different groups of patients as well as potential risks and caveats will be discussed in this review.
SUMMARY
CONCLUSIONS
Interferon-free (IFN-free) treatment not only shortens treatment duration, but also achieves high rates of viral clearance and is overall well tolerated. Genotype-restricted but also pangenotypic combinations are available. Usually two DAA of different drug classes are combined. For the majority of the patients, treatment duration ranges from 8 to 12 weeks. Liver and kidney function as well as prior treatment experience and potential drug-drug interactions influence substance choices and treatment duration. However, modern IFN-free treatment is not only safer, but also overall far more simplified and effective. Global HCV eradication might be an ambitious but not completely unrealistic goal to pursue.
KEY MESSAGES
CONCLUSIONS
IFN-free antiviral treatment is safe and well tolerated. Patients can be treated almost independently of liver function or concomitant disease. Viral eradication is associated with reduced morbidity and mortality and better quality of life.
Identifiants
pubmed: 31367613
doi: 10.1159/000500963
pii: vis-0035-0161
pmc: PMC6616049
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
161-170Déclaration de conflit d'intérêts
L.S. and B.S. have no conflict of interest to declare. M.P.M. received speaker and/or consulting fees and/or grant/research support from AbbVie, BMS, Gilead, Merck/MSD and Janssen. B.M. received speaker and/or consulting fees from Abbott Molecular, Astellas, Intercept, Falk, AbbVie, Bristol-Myers Squibb, Fujirebio, Janssen-Cilag, Merck/MSD and Roche. He also received research support from Abbott Molecular and Roche.
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