scholarly journals Hepatitis C: A Pharmacological Therapeutic Update

2021 ◽  
Vol 10 (8) ◽  
pp. 1568
Author(s):  
Sonia Santander Ballestín ◽  
David Gómez Martín ◽  
Sara Lorente Pérez ◽  
María José Luesma Bartolomé
Keyword(s):  
Hepatitis C ◽  
Treatment Guidelines ◽  
Phase Iii ◽  
World Health ◽  
Technical Data ◽  
Treatment Regimens ◽  
Phase Ii Studies ◽  
Pubmed Database ◽  
Health Organization ◽  
Direct Acting

(1) Background: Hepatitis C is a high-prevalence disease, representing a global impact health problem. Lately, many changes have been made in treatment guidelines because of the commercialization of second-generation direct-acting antivirals due to their high effectiveness, few side effects and pangenotypic action. We address the pharmacological possibilities available and compare them with the current recommendations of the World Health Organization (WHO). (2) Methods: The search for articles was made through the PubMed database using different search strategies and we consulted technical data sheets of the treatments that have been included in the study. (3) Results: Combinations of “glecaprevir/pibrentasvir”, “sofosbuvir/velpatasvir” and “sofosbuvir/velpatasvir/voxilaprevir” have been recently incorporated. Phase II studies have shown that they are safe and effective therapies with very comfortable posologies and easy therapeutic adherence; furthermore, they suppose shorter treatment duration. Subsequently, phase III studies have shown they were effective for previously treated or compensated cirrhotic patients that previously had more complex treatment regimens. (4) Conclusions: These results suppose a simplification in Hepatitis C therapeutic approach, and open new study possibilities.

scholarly journals Management and Treatment of Hepatitis C: Are There Still Unsolved Problems and Unique Populations?

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1048
Author(s):  
Virginia Solitano ◽  
Maria Corina Plaz Torres ◽  
Nicola Pugliese ◽  
Alessio Aghemo
Keyword(s):  
Hepatitis C ◽  
Previous Treatment ◽  
World Health ◽  
Current Evidence ◽  
Decompensated Cirrhosis ◽  
Drug Side Effects ◽  
Efficacy And Safety ◽  
Current Scenario ◽  
Health Organization ◽  
Direct Acting

Direct-acting antivirals (DAA) have revolutionized the treatment of patients with chronic hepatitis C virus (HCV) infection, possibly leading to HCV elimination by 2030 as endorsed by the World Health Organization (WHO). However, some patients belonging to the so-called unique or special populations are referred to as difficult-to-treat due to unreached sustained virological response, potential drug side effects or interactions or co-morbidities. Several years after the DAA introduction and on the basis of excellent findings in terms of efficacy and safety, some doubts arise around the exact meaning of the special population designation and whether this group of patients actually exists. The aim of this review is to discuss and analyze current evidence on the management and treatment of the so-called “unique populations”. We placed particular emphasis on patients with decompensated cirrhosis, chronic kidney disease (CKD), coinfections, rare genotypes, and previous treatment failure, in order to provide physicians with an updated overview of the actual problems and needs in the current scenario.

scholarly journals Tuberculosis: Development of New Drugs and Treatment Regimens

2021 ◽  
Vol 7 (1) ◽  
pp. 36
Author(s):  
Soedarsono Soedarsono
Keyword(s):  
Treatment Guidelines ◽  
New Drugs ◽  
World Health ◽  
Health Crisis ◽  
Treatment Regimens ◽  
Tb Treatment ◽  
Repurposed Drugs ◽  
Latent Tb Infection ◽  
Health Organization ◽  
Who Guideline

Tuberculosis (TB) still becomes a public health crisis. Drug-resistant TB (DR-TB) becomes a concern as the increasing DR-TB cases in countries with high TB burden. The 2017 World Health Organization (WHO) guideline recommended a combination of TB treatment consisting of 2 months of intensive phase with isoniazid (H), rifampisin (R), pyrazinamid (Z), and ethambutol (E), followed by 4 months of continuation phase with HR daily. WHO has updated DR-TB treatment guidelines several times. In 2016, WHO recommended shorter regimen and individual regimen based on certain conditions. The most updated 2020 WHO guideline recommended the short regimen consisting of all oral drugs as well as changes in the grouping of medicines used in DR-TB regimens in longer/individual regimens. Bedaquiline, delamanid, pretomanid, and sutezolid are new drugs which have been studied for their uses as anti-TB drugs (ATD). Bedaquilin and delamanid, which have passed phase 3 trials, have been approved and recommended by WHO for DR-TB treatment. Repurposed drugs have been used for DR-TB treatment during the time of evaluation of drugs list and regimens for DR-TB treatment. Fluoroquinolones, clofazimine, linezolid, carbapenem, amoxicillin/clavulanic acid are repurposed drugs. TB and DR-TB management will be updated at any time, based on the latest findings in studies, to evaluate and improve the effectiveness of current treatments. Prevention of active TB disease by the treatment of latent TB infection (LTBI) is also a critical component of the end TB strategy by WHO. Therefore, the development of new drugs for the LTBI treatment is also needed.

scholarly journals ADME and Pharmacokinetic Properties of Remdesivir: Its Drug Interaction Potential

2021 ◽  
Vol 14 (7) ◽  
pp. 655
Author(s):  
Subrata Deb ◽  
Anthony Allen Reeves ◽  
Robert Hopefl ◽  
Rebecca Bejusca
Keyword(s):  
Drug Interaction ◽  
Ebola Virus ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
World Health ◽  
Nucleoside Triphosphate ◽  
Treatment Regimens ◽  
Global Pandemic ◽  
The World ◽  
Health Organization

On 11 March 2020, the World Health Organization (WHO) classified the Coronavirus Disease 2019 (COVID-19) as a global pandemic, which tested healthcare systems, administrations, and treatment ingenuity across the world. COVID-19 is caused by the novel beta coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Since the inception of the pandemic, treatment options have been either limited or ineffective. Remdesivir, a drug originally designed to be used for Ebola virus, has antiviral activity against SARS-CoV-2 and has been included in the COVID-19 treatment regimens. Remdesivir is an adenosine nucleotide analog prodrug that is metabolically activated to a nucleoside triphosphate metabolite (GS-443902). The active nucleoside triphosphate metabolite is incorporated into the SARS-CoV-2 RNA viral chains, preventing its replication. The lack of reported drug development and characterization studies with remdesivir in public domain has created a void where information on the absorption, distribution, metabolism, elimination (ADME) properties, pharmacokinetics (PK), or drug-drug interaction (DDI) is limited. By understanding these properties, clinicians can prevent subtherapeutic and supratherapeutic levels of remdesivir and thus avoid further complications in COVID-19 patients. Remdesivir is metabolized by both cytochrome P450 (CYP) and non-CYP enzymes such as carboxylesterases. In this narrative review, we have evaluated the currently available ADME, PK, and DDI information about remdesivir and have discussed the potential of DDIs between remdesivir and different COVID-19 drug regimens and agents used for comorbidities. Considering the nascent status of remdesivir in the therapeutic domain, extensive future work is needed to formulate safer COVID-19 treatment guidelines involving this medication.

scholarly journals "Sell an Ox" - The Price of Cure for Hepatitis C in Two Countries

2019 ◽  
Author(s):  
Ora Paltiel ◽  
Workagegnehu Hailu ◽  
Zenahebezu Abay ◽  
Avram Mark Clarfield ◽  
Martin McKee
Keyword(s):  
Hepatitis C ◽  
Universal Access ◽  
The United States ◽  
World Health ◽  
Health Coverage ◽  
Household Assets ◽  
Severe Liver Disease ◽  
Health Organization ◽  
Direct Acting ◽  
New Treatments

Chronic hepatitis C virus (HCV) infection, associated with severe liver disease and cancer, affects 70 million people worldwide. New treatments with direct-acting-antivirals offer cure for about 95% of affected individuals; however, treatment costs may be prohibitive in both the poorest and richest nations. Opting for cure may require sacrificing essential household assets. We highlight the financial dilemmas involved, drawing parallels between Ethiopia and the United States, countries where universal health coverage does not yet exist. The World Health Organization (WHO) declaration for HCV eradication by 2030 will only become reality if universal access to efficacious and affordable treatment is guaranteed for everyone.

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 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 Alcohol Use Disorder and Hepatitis C Prevention and Care in People Who Inject Drugs: The State of Play

2020 ◽  
Author(s):  
Fabienne Marcellin ◽  
Antoine Jaquet ◽  
Jeffrey V. Lazarus ◽  
Patricia Molina ◽  
Patrizia Carrieri
Keyword(s):  
Hepatitis C ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
People Who Inject Drugs ◽  
World Health ◽  
Future Research ◽  
Prevention Interventions ◽  
Cascade Of Care ◽  
Health Organization ◽  
Direct Acting

AbstractSafe and effective treatment with direct-acting antivirals (DAAs) has ushered in an era in which hepatitis C virus (HCV) elimination, as set out by the World Health Organization, is possible. However, alcohol use disorder (AUD) has the potential to reduce the benefits of prevention interventions and reduce access to and continuity of HCV care in at-risk populations, such as people who inject drugs (PWID). We review the literature on the consequences of AUD on the effectiveness of HCV prevention and the cascade of care in PWID and provide recommendations for future research in the field of alcohol use and HCV.

Long-Term Impact of Direct-Acting Antiviral Agent Therapy in HCV Cirrhosis: Critical Review

2019 ◽  
Vol 39 (03) ◽  
pp. 341-353 ◽  
Author(s):  
Sasha R. Fehily ◽  
Tim Papaluca ◽  
Alexander J. Thompson
Keyword(s):  
Hepatitis C ◽  
Effective Means ◽  
Antiviral Agents ◽  
Antiviral Agent ◽  
World Health ◽  
Curative Therapy ◽  
Direct Acting Antiviral ◽  
Related Liver Disease ◽  
Health Organization ◽  
Direct Acting

AbstractMore than 70 million people are chronically infected with hepatitis C virus (HCV) worldwide. Chronic hepatitis C is associated with progressive liver fibrosis, which can result in cirrhosis, liver failure, and hepatocellular carcinoma (HCC). HCV-related liver disease has been the most common indication for liver transplantation in the past decade. The development of direct-acting antiviral agents (DAAs) that are simple, well-tolerated, and highly effective means that most people living with hepatitis C can now be cured, leading the World Health Organization to set targets for reduction in deaths due to viral hepatitis by 2030. In this review, the authors will consider the emerging data showing that curative therapy with DAAs can prevent HCV-related morbidity and mortality, with a focus on patients with HCV-related cirrhosis.

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.

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