scholarly journals Why and How to Treat Chronic Hepatitis C

2000 ◽  
Vol 14 (suppl b) ◽  
pp. 45B-48B ◽  
Author(s):  
Stephanos J Hadziyannis
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Combination Therapy ◽  
Chronic Hepatitis C ◽  
Cost Effective ◽  
Genotype 1 ◽  
Related Factors ◽  
Major Health Problem ◽  
Hcv Genotype ◽  
End Stage

Chronic hepatitis C (CHC) is a major health problem worldwide, with approximately 200 million affected individuals and a significant rate of progression to end-stage cirrhosis and hepatocellular carcinoma (HCC). If hepatitis C virus (HCV) infection is left untreated in the population, then the number of liver-related deaths will soon double and the need for liver transplantation may increase to five times that seen today. Available therapies for CHC are restricted to interferon alpha (IFN-α ) monotherapy and to the combination of IFN-α and ribavirin. Despite their high cost and side effects, both of these therapies have proved to be cost effective, particularly combination therapy. IFN-α monotherapy for one year can induce sustained response (SR) rates of approximately 10% in naive patients infected with HCV genotype 1, and above 50% in those infected with other genotypes. Combination therapy can double or even triple the rate of SR in genotype 1 infections and may further increase the SR rate in the other HCV genotypes. Combination therapy has also been proven to be effective in approximately 50% of relapsed responders to IFN-α monotherapy. In clinical practice, the decision to treat should be individualized and tailored on the basis of several virus- and host-related factors, particularly the grade and stage of liver disease, HCV genotype and levels of viremia. Appropriate monitoring of therapy by careful clinical evaluation, liver biochemistry and serumHCVRNAtesting is mandatory. IFN-α therapy may also prove to be effective in reducing the rate of HCC development in CHC regardless of whether a virological response is achieved, but this remains to be established.

scholarly journals Review of Boceprevir and Telaprevir for the Treatment of Chronic Hepatitis C

2012 ◽  
Vol 26 (4) ◽  
pp. 205-210 ◽  
Author(s):  
Kyle J Wilby ◽  
Nilufar Partovi ◽  
Jo-Ann E Ford ◽  
Erica D Greanya ◽  
Eric M Yoshida
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Cost Effective ◽  
Pegylated Interferon ◽  
Future Research ◽  
Genotype 1 ◽  
Hepatitis C Infection ◽  
Manual Search ◽  
Cost Effective Treatment

OBJECTIVE: To summarize and evaluate the published literature pertaining to boceprevir and telaprevir, and to provide clinicians with suggestions for use in patients with chronic hepatitis C infection.METHODS: A standardized search strategy was performed using the MEDLINE, EMBASE, Google Scholar and International Pharmaceuticals Abstracts databases using the search terms “boceprevir”, “telaprevir”, “boceprevir and hepatitis C” and “telaprevir and hepatitis C”. A manual search of references was performed to identify articles missed by the electronic search. Studies were included in the review if they assessed either boceprevir or telaprevir in comparison with standard of care in chronic hepatitis C patients.RESULTS: The studies identified assessed boceprevir and telaprevir in genotype-1 hepatitis C patients. In both treatment-naive and treatment-experienced patients, sustained virological response rates were achieved more often with boceprevir or telaprevir in combination with pegylated interferon and ribavirin compared with pegylated interferon and ribavirin alone. Both medications were well tolerated, with anemia presenting as the most treatment-limiting adverse effect.CONCLUSIONS: Boceprevir and telaprevir will revolutionize the management of hepatitis C genotype 1 patients and will most likely decrease the burden of end-stage disease worldwide. However, current clinical limitations include establishing appropriate and cost-effective treatment durations, and use in special populations such as transplant patients and patients coinfected with HIV. Future research will need to clarify these clinical obstacles to clearly define the role of these agents in hepatitis C management.

Chronic hepatitis C genotype 6 responds better to pegylated interferon and ribavirin combination therapy than genotype 1

2010 ◽  
Vol 25 (4) ◽  
pp. 766-771 ◽  
Author(s):  
Owen T-Y Tsang ◽  
Jonpaul S-T Zee ◽  
Jacky M-C Chan ◽  
Reggie S-T Li ◽  
Yee-Man Kan ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Combination Therapy ◽  
Chronic Hepatitis C ◽  
Pegylated Interferon ◽  
Genotype 1

scholarly journals The Impact of Interleukin-28B rs12979860 Polymorphism on Peginterferon-alpha and Ribavirin Combination Therapy in Iranian Patients with Hepatitis C Virus Genotype 1 Infection

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Mahboubeh Hajiabdolbaghi ◽  
Reza Shahsiah ◽  
Mahsa Motavaf ◽  
Tabasom Zavari
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Combination Therapy ◽  
Treatment Response ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
Genotype 1 ◽  
Interleukin 28B ◽  
Iranian Patients

Background: Hepatitis C virus (HCV) infection is a global health problem. Most cases of HCV infection do not resolve spontaneously. Combination therapy with pegylated interferon-α (PegIFN-alpha) and ribavirin (RBV) is the standard treatment for patients with HCV infection. The success of treatment is affected by several host, viral, and treatment factors. Available works have demonstrated significant role of interleukin 28B (IL28B) polymorphisms in predicting HCV infection treatment outcomes. This suggests the possibility of tailored therapy in HCV infected patients. HCV is one of the most common causes of liver disease worldwide. If untreated, this infection can develop chronic hepatitis in 50%-85% of patients. The aim of current study is to determine the association of interleukin-28B (IL-28B) rs-12979860 polymorphism in response to peginterferon-alpha (PegIFN-alpha) and ribavirin combination therapy in Iranian patients with chronic hepatitis C genotype 1 infection. Methods: This cross-sectional study was carried out on 70 Iranian patients with chronic hepatitis C infection (genotype 1) receiving PegIFN-alpha and ribavirin. DNA was extracted from blood samples. Specific primers were used to amplify targeted polymorphisms. Results: In this study, 71.4% of patients reached sustained virological response (SVR). The prevalence of CC, CT and TT genotypes were 38.6%, 42.8% and 18.6% respectively. The rate of SVR was 96.3 for CC genotype, whereas this rate was 66.7 for CT and 30.8 for TT genotypes. We found an association between end of treatment response (ETR) and IL-28B genotypes as 100% of patients bearing CC genotype reached ETR, but ETR rate was 45.85% in CT group and 10.2% in TT group. Six months follow-up showed that there was a significant difference between response to treatment in patients IL-28B-CC and TT (P < 0.001). Data regression analysis showed that CC genotype was an independent predicting factor, significantly associated with higher SVR (P = 0.005 (OR=36.1; 95% CI = 3 - 434.2)). In contrast, absence of C allele (TT genotype) was significantly correlated with the failure of response (P = 0.005 (OR = 36.1; 95% CI = 3 - 434.2)). Conclusions: The results showed that IL-28B rs12979860 was an important predictor of HCV treatment response.

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