APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

Abstract

The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on ''APASL consensus statements and recommendations for management of hepatitis C'' in March 2015 to revise the ''APASL consensus statements and management algorithms for hepatitis C virus infection'' (Hepatol Int 6:409-435, 2012). The working party consisted of expert hepatologists from the Asian-Pacific region gathered at the Istanbul Congress Center, Istanbul, Turkey on 13 March 2015. New data were presented, discussed, and debated during the course of drafting a revision. Participants of the consensus meeting assessed the quality of the cited studies. The finalized recommendations for hepatitis C prevention, epidemiology, and laboratory testing are presented in this review.

Hepatitis C Virus: A Review of Treatment Guidelines, Cost-effectiveness, and Access to Therapy

“…A study in Asia showed that up to 50% of patients with HCV are deemed unsuitable for treatment with IFN. Additionally, IFN therapy in Asian countries is often limited to major treatment centers, with limited access to isolated areas due to the infrastructure needed to ensure safety and appropriate treatment 10. According to a study by Wedemeyer et al,11 given the nature of IFN-based treatment, treatment response rates have been reported as low as 5%, even in countries with diagnosis rates greater than 50% 10…”

Turkey 2017 Clinical Practice Guidelines on recommendations for screning diagnosing and managing hepatitis C virus

“…Patients should also be educated about the crucial importance of adherence to drugs, and the necessity for close supervision and laboratory tests during and after antiviral treatment. (2)(3)(4)(5)(6) The following points should be covered in detail (2-6):…”

“…HCV is primarily transmitted through percutaneous exposure to blood and blood products, mother-to-infant, contaminated devices shared with drug uses and sexual transmission (2)(3)(4)(5). HCV is not spread by hugging, holding hands, sneezing, coughing, or sharing eating materials or drinking glasses.…”

Sofosbuvir/velpatasvir: a pangenotypic drug to simplify HCV therapy

“…Hepatitis C is a global health problem, and though the pangenotypic activity of SOF/VEL provides a wide-ranging therapy, specific populations with variable host genetics may benefit from tailored treatment plans. The high frequency of the favorable IL28B genotype, a single-nucleotide polymorphism (SNP) near the interleukin-28B gene, may contribute to high spontaneous HCV clearance in Asian populations [36]. The IL-28B gene does not appear to significantly alter DAA treatment outcome; however, per The Asian Pacific Association for the Study of the Liver (APASL) guidelines, IL28B genotyping could be clinically useful in interferon-based therapy [36].…”

“…The high frequency of the favorable IL28B genotype, a single-nucleotide polymorphism (SNP) near the interleukin-28B gene, may contribute to high spontaneous HCV clearance in Asian populations [36]. The IL-28B gene does not appear to significantly alter DAA treatment outcome; however, per The Asian Pacific Association for the Study of the Liver (APASL) guidelines, IL28B genotyping could be clinically useful in interferon-based therapy [36]. The ASTRAL studies provided basic information about SVR obtained by race, and no information was specific for Asian patients.…”