An Update on the Management of Chronic Hepatitis C: Consensus Guidelines from the Canadian Association for the Study of the Liver

Chronic hepatitis C remains a significant medical and economic burden in Canada, affecting nearly 1% of the population. Since the last consensus conference on the management of chronic hepatitis C, major advances have warranted a review of recommended management approaches for these patients. Specifically, direct-acting antiviral agents with dramatically improved rates of virological clearance compared with standard therapy have been developed, and several single nucleotide polymorphisms associated with an increased probability of spontaneous and treatment-induced viral clearance have been identified. In light of this new evidence, a consensus development conference was held in November 2011; the present document highlights the results of the presentations and discussions surrounding these issues. It reviews the epidemiology of hepatitis C in Canada, preferred diagnostic testing approaches and recommendations for the treatment of chronically infected patients with the newly approved protease inhibitors (boceprevir and telaprevir), including those who have previously failed pegylated interferon and ribavirin therapy. In addition, recommendations are made regarding approaches to reducing the burden of hepatitis C in Canada.

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An Update on the Management of Chronic Hepatitis C: 2015 Consensus Guidelines from the Canadian Association for the Study of the Liver

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2015/692408 ◽

2015 ◽

Vol 29 (1) ◽

pp. 19-34 ◽

Cited By ~ 41

Author(s):

Robert P Myers ◽

Hemant Shah ◽

Kelly W Burak ◽

Curtis Cooper ◽

Jordan J Feld

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Diagnostic Testing ◽

Antiviral Agents ◽

Consensus Conference ◽

Consensus Guidelines ◽

Direct Acting Antiviral ◽

Canadian Association ◽

Management Approaches

Chronic hepatitis C remains a significant medical and economic burden in Canada, affecting nearly 1% of the population. Since the last Canadian consensus conference on the management of chronic hepatitis C, major advances have occurred that warrant a review of recommended management approaches for these patients. Specifically, direct-acting antiviral agents with dramatically improved rates of virological clearance compared with standard therapy have been developed and interferon-free, all-oral antiviral regimens have been approved. In light of this new evidence, an update to the 2012 Canadian Association for the Study of the Liver consensus guidelines on the management of hepatitis C was produced. The present document reviews the epidemiology of hepatitis C in Canada, preferred diagnostic testing approaches and recommendations for the treatment of chronically infected patients with the newly approved antiviral agents, including those who have previously failed peginterferon and ribavirin-based therapy. In addition, recommendations are made regarding approaches to reducing the burden of hepatitis C in Canada.

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Sofosbuvir: an all-around drug in hepatitis C treatment new era – The first phase

Reviews in Health Care ◽

10.7175/rhc.v6i2.1164 ◽

2015 ◽

Vol 6 (2) ◽

pp. 41-52

Author(s):

Alessia Ciancio

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Protease Inhibitor ◽

Chronic Hepatitis C ◽

Antiviral Agents ◽

Sustained Viral Response ◽

Clinical Effectiveness ◽

Pegylated Interferon ◽

Direct Acting Antiviral ◽

Ns5b Polymerase Inhibitor

Chronic hepatitis C virus (HCV) infection is a slowly progressive disease affecting more than 185 million people worldwide. For many years, the combination of pegylated interferon (Peg-IFN) plus ribavirin (RBV) has been the backbone of treatment for patients infected with HCV. More than two years ago, the first generation direct-acting antiviral agents (DAAs) – the protease inhibitors boceprevir and telaprevir – were approved for treatment of genotype 1 patients, doubling the cure rate. The new DAAs that have been developed, are effective for multiple genotypes, improve rates of sustained viral response with fewer side effects, simplify dosing and drug-drug interactions, and in some patients, offer the promise of interferon-free and/or ribavirin-free therapy. These new agents include the recently approved second generation protease inhibitor, the HCV NS5B polymerase inhibitor sofosbuvir and the NS3/4A protease inhibitor simeprevir as well as several other agents that are currently in later phases of development. With sofosbuvir-based regimens, successful interferon-free treatment is now available across all genotypes. In fact sofosbuvir is very effective in combination with Peg-interferon and ribavirine or with ribavirine alone or with other direct anti-viral agents. The following assessment evaluates the evidence on the clinical effectiveness and harms of sofosbuvir for the treatment of chronic hepatitis C.

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ANTIVIRAL TREATMENT OF CHRONIC HEPATITISС: AVAILABLE RESULTS AND FUTURE PROSPECTS

Health and Ecology Issues ◽

10.51523/2708-6011.2017-14-1-6 ◽

2017 ◽

pp. 31-35

Author(s):

V. M. Mitsura ◽

E. L. Krasavtsev ◽

S. V. Zhavoronok ◽

E. V. Voropaev ◽

O. V. Osipkina ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Generic Drugs ◽

Antiviral Treatment ◽

Antiviral Agents ◽

Pegylated Interferon ◽

Nucleotide Polymorphisms ◽

Genotype 1 ◽

Hcv Genotype

Objective : to evaluate the effectiveness of two interferon (IFN)-based antiviral therapy of chronic hepatitis C (IFN/RBV or PEG-IFN/RBV)depending on HCV genotype, IL-28B gene mutations and to determinethe group of patients who need treatment with direct antiviral agents. Material and methods. The study involved 844 patients with chronic hepatitis C (60.6 % men; 51.9 % with genotype 1 virus) in two infectious diseases hospitals. 324 patients received treatment with standard interferon and ribavirin (IFN/RBV), 520 patients - with pegylated interferon and ribavirin (PEG-IFN/RBV). Polymerase chain reaction was applied to determinesingle nucleotide polymorphisms (SNPs) rs12979860 and rs8099917 of IL-28B gene. Results. The effectiveness (sustained virologic response, SVR) of the scheme IFN/RBV in patients with HCV genotype 1 was 23.9 %, and of PEG-IFN/RBV - 48.4 %. The highest frequency rate of SVR was recorded in patients with CC variant of SNP rs12979860 - 73.3 and 82.1 % (for IFN/RBV and PEG-IFN/RBV schemes, respectively). Schemes IFN/RBV (SVR 70.8 %) and PEG-IFN/RBV (SVR 86.5 %) were highly effective for patients with HCV genotypes 2 and 3. The treatment was not effective in patients with genotype 1 HCV having gene IL-28B SNPs rs12979860 CT or TT and rs8099917 TG or GG and in patientsover 40. Conclusion. It is prospectiveto use non-IFN regimens based on direct-acting antiviral agents to treat patients with 1 HCV genotype with genotype CT/TT (rs12979860) and TG/GG (rs8099917), as well as those who did not respond previously to the antiviral treatment with PEG-IFN/RBV.The implementation of the non-IFN regimens should be accelerated by means of registration or development of production of generic drugs.

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Pegylated interferon-alfa plus ribavirin therapies for chronic hepatitis C

Journal of Nepal Medical Association ◽

10.31729/jnma.44 ◽

2011 ◽

Vol 51 (181) ◽

Author(s):

T Kanda ◽

O Yokosuka

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Antiviral Agents ◽

Standard Of Care ◽

Pegylated Interferon ◽

New Drugs ◽

Direct Acting Antiviral ◽

New Information ◽

Direct Acting

Until HCV NS3/4A protease inhibitors become available at the end of 2011, the combination pegylated-interferon (PEG-IFN)-alfa and ribavirin (RBV) will remain the standard treatment for chronic hepatitis C patients. In some hepatitis C virus-infected patients, PEG-IFN plus RBV treatment against HCV should continue to be used because of side effects of new drugs such as anemia. Our Japanese experiences should provide new information for the treatment of chronic hepatitis C. Keywords: Direct-acting antiviral agents (DAA), HCV, pegylated interferon, ribavirin, standard of care (SOC ).

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Hepatitis C virus vaccine development: old challenges and new opportunities

National Science Review ◽

10.1093/nsr/nwv040 ◽

2015 ◽

Vol 2 (3) ◽

pp. 285-295 ◽

Cited By ~ 20

Author(s):

Dapeng Li ◽

Zhong Huang ◽

Jin Zhong

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Vaccine Development ◽

Rna Virus ◽

Antiviral Agents ◽

Resistance Mutations ◽

Direct Acting Antiviral ◽

Direct Acting

Abstract Hepatitis C virus (HCV), an enveloped positive-sense single-stranded RNA virus, can cause chronic and end-stage liver diseases. Approximately 185 million people worldwide are infected with HCV. Tremendous progress has been achieved in the therapeutics of chronic hepatitis C thanks to the development of direct-acting antiviral agents (DAAs), but the worldwide use of these highly effective DAAs is limited due to their high treatment cost. In addition, drug-resistance mutations remain a potential problem as DAAs are becoming a standard therapy for chronic hepatitis C. Unfortunately, no vaccine is available for preventing new HCV infection. Therefore, HCV still imposes a big threat to human public health, and the worldwide eradication of HCV is critically dependent on an effective HCV vaccine. In this review, we summarize recent progresses on HCV vaccine development and present our views on the rationale and strategy to develop an effective HCV vaccine.

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