scholarly journals ANTIVIRAL TREATMENT OF CHRONIC HEPATITISС: AVAILABLE RESULTS AND FUTURE PROSPECTS

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.

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

2012 ◽  
Vol 26 (6) ◽  
pp. 359-375 ◽  
Author(s):  
Robert P Myers ◽  
Alnoor Ramji ◽  
Marc Bilodeau ◽  
Stephen Wong ◽  
Jordan J Feld
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Diagnostic Testing ◽  
Antiviral Agents ◽  
Pegylated Interferon ◽  
Consensus Conference ◽  
Nucleotide Polymorphisms ◽  
Direct Acting Antiviral ◽  
Canadian Association

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.

scholarly journals Pleuro-Pulmonary Nocardiosis as Opportunistic Infection in a Patient with Chronic Hepatitis C under Combination Treatment with Pegylated Interferon, Ribavirin, and Boceprevir

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Csilla Putz-Bankuti ◽  
Harald H. Kessler ◽  
Thomas Valentin ◽  
Eva Leitner ◽  
Emina Talakic ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Pulmonary Infection ◽  
Antiviral Treatment ◽  
Pegylated Interferon ◽  
Hepatitis C Virus Infection ◽  
Chronic Hepatitis C Virus ◽  
Aerobic Actinomycetes

Nocardiosis is an infrequent but serious pulmonary infection caused by Gram-positive aerobic actinomycetes. In this paper, we report on a 48-year-old patient with pleuropulmonary nocardiosis and cirrhosis due to chronic hepatitis C virus infection treated with triple antiviral treatment complicated by prolonged neutropenia.

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.

A Review on the Use of Eltrombopag in Patients with Advanced Liver Disease

2009 ◽  
Vol 1 ◽  
pp. CMT.S2267
Author(s):  
Edoardo G. Giannini ◽  
Alfredo Greco ◽  
Vincenzo Savarino
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Pegylated Interferon ◽  
Severe Thrombocytopenia ◽  
Current Standard ◽  
Advanced Liver Disease ◽  
Orally Bioavailable

Thrombocytopenia is the most common hematological abnormality in patients with chronic, advanced liver disease. In these patients, the presence of severe thrombocytopenia is an obstacle to the performance of invasive diagnostic and therapeutic procedures, and the current standard treatment for these patients is platelet transfusions, a remedy whose characteristics are far from being ideal. Furthermore, thrombocytopenia in patients with chronic hepatitis C virus infection may render the patients ineligible to antiviral treatment or may limit its efficacy because of premature discontinuation. Although the cause of thrombocytopenia in patients with chronic liver disease is likely multi-factorial, decreased thrombopoietin production by the liver undoubtedly plays a significant role. In this regard, eltrombopag, a non-peptide, orally bioavailable thrombopoietin receptor agonist has been shown to safely increase platelet count in a dose-dependent fashion in both healthy subjects and thrombocytopenic patients with chronic hepatitis C. Furthermore, in this latter group of patients, it has been shown to be superior to placebo in counteracting the myelosuppressive effect of short-term pegylated interferon treatment.

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