scholarly journals A hepatitis C-vírus (HCV) három évtizede a felfedezéstől a globális elimináció lehetőségéig: a transzlációs kutatás sikere

2018 ◽  
Vol 159 (12) ◽  
pp. 455-465 ◽  
Author(s):  
Alajos Pár ◽  
Gabriella Pár
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health Sector ◽  
World Health ◽  
Direct Acting Antivirals ◽  
Treatment Plans ◽  
Health Organization ◽  
Direct Acting ◽  
Evidence Based Guidelines

Abstract: More than 25 years after the discovery of hepatitis C virus, the development of the direct acting antivirals can lead to the regional or long-term global elimination of the virus with over 90% efficacy. This is the success of basic and clinical translational research. Yet, some unsolved challanges remain, such as the great number of unidentified patients who are not aware of their condition, the limited access to the therapy due to the high prices of the drugs, and the treatment of resistance-associated variants. In addition, the lack of vaccine is also an obstacle. In 2016, the World Health Organization (WHO) developed the first global health sector strategy for the elimination of viral hepatitis by 2030. Its evidence-based guidelines are primarily targeted at the national hepatitis programme managers who are responsible for the national testing and treatment plans. According to these recommendations, it is of basic importance to perform focused risk-based testing in higher-risk populations and after diagnosis to start treatment as “cure as prevention”, furthermore, to limit the risk of reinfection. We review the events of the HCV story from the discovery to these days, including virology, epidemiology, pathogenesis, diagnosis and therapy. Orv Hetil. 2018; 159(12): 455–465.

scholarly journals Remission of long-term hepatic and renal disease induced by HCV after direct-acting antivirals therapy

2020 ◽  
Author(s):  
Raissa M Arruda ◽  
Andrea D Batista ◽  
Norma A Filgueira ◽  
Izolda F Moura ◽  
Luis H Sette ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Side Effects ◽  
Renal Diseases ◽  
Direct Acting Antivirals ◽  
Direct Acting ◽  
Autoimmune Phenomena

Abstract In addition to liver disease, the hepatitis C virus (HCV) has been associated with autoimmune phenomena, such as mixed cryoglobulin and glomerulonephritis (GN). Until recently, both chronic hepatitis and HCV extra-hepatic manifestations were treated with peg-interferon plus ribavirin, however these drugs presented low efficacy and induced severe side effects. Nowadays, the HCV chronic hepatitis has been treated with direct acting antivirals (DAA), but studies on the DAA therapy for HCV-associated glomerulonephritis are scarce. Here, we describe two cases of HCV-associated glomerulonephritis that were treated with DAAs. In these two cases, previously experienced to peg-interferon plus ribavirin, the sofosbuvir plus simeprevir therapy was effective, without significant side effects, and interrupted the evolution of at least 20 years of both hepatic and renal diseases. These cases join the seven previously described cases that were treated with this DAAs association.

scholarly journals Simplification of Care for Chronic Hepatitis C Virus Infection

2020 ◽  
Vol 40 (04) ◽  
pp. 392-402 ◽  
Author(s):  
Jean-Michel Pawlotsky ◽  
Christian B. Ramers ◽  
John F. Dillon ◽  
Jordan J. Feld ◽  
Jeffrey V. Lazarus
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Scale Up ◽  
Linkage To Care ◽  
World Health ◽  
Direct Acting Antiviral ◽  
Hcv Screening ◽  
Health Organization ◽  
Chronic Hcv ◽  
Direct Acting

AbstractIn 2016, the World Health Organization (WHO) set a target for eliminating viral hepatitis as a major public health threat by 2030. However, while today's highly effective and well-tolerated pangenotypic direct-acting antiviral regimens have maximized simplification of hepatitis C virus (HCV) treatment, there remain a plethora of barriers to HCV screening, diagnosis, and linkage to care. As of 2017, only 19% of the estimated 71 million individuals living with chronic HCV worldwide were diagnosed and in 2015 to 2016, only 21% of diagnosed individuals had accessed treatment. Simplification and decentralization of the HCV care cascade would bolster patient engagement and support the considerable scale-up needed to achieve WHO targets. Recent developments in HCV screening and diagnosis, together with reduced pretreatment assessment and on-treatment monitoring requirements, can further streamline the care continuum, ensuring patients are linked to care quickly and earlier in the disease course, and minimize clinic visits.

scholarly journals Hepatitis C Virus and Hepatocellular Carcinoma: When the Host Loses Its Grip

2020 ◽  
Vol 21 (9) ◽  
pp. 3057
Author(s):  
Kaku Goto ◽  
Armando Andres Roca Suarez ◽  
Florian Wrensch ◽  
Thomas F. Baumert ◽  
Joachim Lupberger
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Viral Proteins ◽  
Virologic Response ◽  
Direct Acting Antivirals ◽  
Advanced Liver Disease ◽  
Novel Treatments ◽  
Direct Acting

Chronic infection with hepatitis C virus (HCV) is a major cause of hepatocellular carcinoma (HCC). Novel treatments with direct-acting antivirals achieve high rates of sustained virologic response; however, the HCC risk remains elevated in cured patients, especially those with advanced liver disease. Long-term HCV infection causes a persistent and accumulating damage of the liver due to a combination of direct and indirect pro-oncogenic mechanisms. This review describes the processes involved in virus-induced disease progression by viral proteins, derailed signaling, immunity, and persistent epigenetic deregulation, which may be instrumental to develop urgently needed prognostic biomarkers and as targets for novel chemopreventive therapies.

Hepatitis C: prescribing challenges in the era of new direct-acting antivirals

2019 ◽  
Vol 1 (2) ◽  
pp. 80-85
Author(s):  
Lindsay Chalmers
Keyword(s):  
Hepatitis C ◽  
Treatment Options ◽  
New Drugs ◽  
World Health ◽  
Side Effect Profile ◽  
Direct Acting Antivirals ◽  
Public Health Burden ◽  
The World ◽  
Health Organization ◽  
Direct Acting

Hepatitis C is a chronic but curable disease. The World Health Organization has recognised the huge public health burden that untreated and undiagnosed hepatitis C can cause worldwide and has set a target to eliminate the disease by 2030. The treatment landscape is rapidly evolving, and newer therapies are more effective and have an improved side effect profile. Treatment has become widely available and prescribers have a myriad of new drugs to become familiar with. This article will focus on the more novel therapies, guidelines and treatment options and the challenges facing the prescriber in the age of direct-acting antivirals.

scholarly journals Real-world efficacy and safety of pangenotypic direct-acting antivirals against hepatitis C virus infection in Taiwan

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kao-Chi Chang ◽  
Shui-Yi Tung ◽  
Kuo-Liang Wei ◽  
Chen-Heng Shen ◽  
Yung-Yu Hsieh ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Real World ◽  
Population Analysis ◽  
Virologic Response ◽  
Efficacy And Safety ◽  
Hepatitis C Virus Infection ◽  
Direct Acting Antivirals ◽  
Evaluable Population ◽  
Direct Acting

AbstractClinical trials showed pangenotypic direct-acting antivirals’ (DAAs) excellent efficacy and safety when treating hepatitis C virus (HCV). Two pangenotypic regimens were examined, glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/velpatasvir (SOF/VEL), in a real-world Taiwanese setting, including all HCV patients treated with GLE/PIB or SOF/VEL from August 2018 to April 2020. The primary endpoint was sustained virologic response 12 weeks after treatment cessation (SVR12), including adverse events (AEs). A total of 1,356 HCV patients received pangenotypic DAA treatment during the study: 742 and 614 received GLE/PIB and SOF/VEL, respectively. The rates of SVR12 for GLE/PIB and SOF/VEL were 710/718 (98.9%) and 581/584 (99.5%), respectively, by per-protocol analysis, and 710/742 (95.7%) and 581/614 (94.6%), respectively, by evaluable population analysis. Eleven (GLE/PIB: 8, SOF/VEL: 3) did not achieve SVR12. The most common AEs for GLE/PIB and SOF/VEL were pruritus (17.4% vs. 2.9%), abdominal discomfort (5.8% vs. 4.4%), dizziness (4.2% vs. 2%), and malaise (3.1% vs. 2.9%). Laboratory abnormalities were uncommon; only < 1% exhibited elevated total bilirubin or aminotransferase levels with both regimens. Five drug discontinuations occurred due to AEs (bilirubin elevation: 3; dermatological issues: 2). Pangenotypic DAAs GLE/PIB and SOF/VEL are effective and well tolerated, achieving high SVR12 rates for patients with all HCV genotypes.

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