Diagnosis, management, and treatment of hepatitis C: An update # † ‡

Ghany, Marc G.; Strader, Doris B.; Thomas, David L.; Seeff, Leonard B.

doi:10.1002/hep.22759

Cited by 2,722 publications

(2,709 citation statements)

References 432 publications

(505 reference statements)

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“…1 The World Health Organisation (WHO) and international consensus conferences refer to the high chronification rate of HCV infection, the risk of subsequent HCV-related complications, including end-stage liver cirrhosis and hepatocellular carcinoma (HCC) and the high costs for antiviral therapy, respectively, liver transplantation (LT). 2,3 It is estimated that HCV-related morbidity and mortality will increase in the next decade. [4][5][6] The predicted cumulative probability of cirrhosis approximates 20% at 20 years after HCV infection and increases to 45% at 30 years after infection.…”

mentioning

confidence: 99%

Evaluation of liver disease progression in the German hepatitis C virus (1b)-contaminated anti-D cohort at 35 years after infection

Wiese¹,

Fischer

Löbermann

et al. 2013

Hepatology

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The natural course of HCV infection remains controversial. The German HCV (1b)-contaminated anti-D cohort provides an ideal population to investigate the natural course of HCV infection in a large, homogenous cohort of young women from the date of HCV inoculation. Our previous follow-up studies at 20 and 25 years after infection suggested slow fibrosis progression rates in this unique cohort. The aim of our prospective, community-based, multicenter study was to reevaluate the liver disease progression in 718 patients of the original anti-D cohort at 35 years after infection. Patients with self-limited HCV infection (n 5 189) were compared to those who failed to eliminate the virus spontaneously (n 5 529), comprising patients who were treatment na€ ıve (n 5 197) or achieved a sustained virological response (SVR; n 5 149), respectively, failed to clear the virus (non-SVR; n 5 183) after antiviral therapy. In the overall cohort, 9.3% of patients showed clinical signs of liver cirrhosis at 35 years after infection. Liver disease progression largely depended on HCV infection status. The highest proportion of patients with clinical signs of end-stage liver disease was observed in the non-SVR group (15.3%), whereas decreased cirrhosis rates were detected in the SVR group (6%) and in patients with self-limited HCV infection (1.1%; P 5 6.2 3 10 26 ). Overall survival was significantly enhanced after SVR, compared to treatment-na€ ıve patients or non-SVR (P 5 0.027). Conclusion: The present study provides further evidence for a mild, but significant, disease progression at 35 years after infection in the German HCV (1b)-contaminated anti-D cohort. Patients with self-limited HCV infection or SVR after antiviral treatment were protected from progressive liver disease and showed the best clinical long-term outcome. (HEPATOLOGY 2014;59:49-57) H epatitis C virus (HCV) infection is the leading cause of end-stage liver disease (ESLD) in the world and represents a major burden for national health systems. 1 The World Health Organisation (WHO) and international consensus conferences refer to the high chronification rate of HCV infection, the risk of subsequent HCV-related complications, including end-stage liver cirrhosis and hepatocellular carcinoma (HCC) and the high costs for antiviral therapy, respectively, liver transplantation (LT). 2,3 It is estimated that HCV-related morbidity and mortality will increase in the next decade. [4][5][6] The predicted cumulative probability of cirrhosis approximates 20% at 20 years after HCV infection and

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mentioning

confidence: 99%

Evaluation of liver disease progression in the German hepatitis C virus (1b)-contaminated anti-D cohort at 35 years after infection

Wiese¹,

Fischer

Löbermann

et al. 2013

Hepatology

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“…Until recently, the standard of care for chronic HCV infection in pediatric patients was pegylated IFN in combination with RBV (GT2 and GT3, 24‐week treatment; HCV GT1 and GT4, 48‐week treatment) 11, 12. In children infected with GT2 and GT3, the SVR rate was approximately 90%; with GT1 and GT4, the SVR rate was approximately 48% 13, 25.…”

Section: Discussionmentioning

confidence: 99%

“…The standard of care treatment for children with chronic HCV infection was until recently pegylated IFN in combination and RBV 11, 12. In 2017, the European Medicines Agency and the U.S. Food and Drug Administration (FDA) approved the use of the nonstructural protein 5B (NS5B) polymerase inhibitor sofosbuvir with RBV for HCV GT2 and GT3 and the fixed‐dose combination of sofosbuvir plus the NS5A inhibitor ledipasvir for HCV GT1, GT4, GT5, and GT6 for the treatment of adolescents (12 years or older, or weighing at least 35 kg) with chronic HCV infection.…”

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confidence: 99%

Ombitasvir/Paritaprevir/Ritonavir With or Without Dasabuvir and With or Without Ribavirin for Adolescents With HCV Genotype 1 or 4

Leung

Wirth

Yao

et al. 2018

Hepatology Communications

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In adults, treatment of hepatitis C virus (HCV) infection with ombitasvir (OBV)/paritaprevir (PTV)/ritonavir (r) with or without dasabuvir (DSV) and ±ribavirin (RBV) results in high rates of sustained virologic response (SVR). However, these regimens have not been investigated in adolescents. This ongoing, open‐label, phase 2/3 study evaluated the pharmacokinetics, safety, and efficacy of OBV/PTV/r+DSV±RBV treatment for 12 weeks in adolescents infected with HCV genotype (GT) 1 without cirrhosis (part 1) and the safety and efficacy of OBV/PTV/r±DSV±RBV treatment for 12 or 24 weeks in adolescents infected with GT1 or GT4 without cirrhosis or with compensated cirrhosis (parts 1 and 2). Patients were 12‐17 years of age and treatment naive or interferon experienced. Treatment regimens were based on HCV GT and cirrhosis status. Endpoints were SVR at posttreatment week 12 (SVR12), adverse events (AEs), and pharmacokinetic parameters. Thirty‐eight adolescents were enrolled, 66% were female patients, and 76% were White; 42%, 40%, and 18% of patients had HCV GT1a, GT1b, and GT4 infections, respectively. Median age was 15 years (range, 12‐17 years), and 1 patient had cirrhosis. The SVR12 rate was 100% (38/38; 95% confidence interval [CI], 90.8%‐100%). No treatment‐emergent grade 3 or 4 laboratory abnormalities were reported. No serious AEs occurred on treatment, and no AEs led to study drug discontinuation. The most common AEs were headache (21%), fatigue (18%), nasopharyngitis (13%), pruritus (13%), and upper respiratory tract infection (11%). Intensive pharmacokinetic results showed OBV, PTV, DSV, and ritonavir drug exposures were comparable to those seen in adults. Conclusion: Treatment with OBV/PTV/r±DSV±RBV was well tolerated and highly efficacious in adolescents with HCV GT1 or GT4 infection.

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“…16,17 The availability of these new treatments is critical, as complications in long-term hepatitis C infection (liver failure, hepatocellular carcinoma, and mortality) are rising dramatically, and are expected to continue to rise. 18 Since the prisoner population has a high burden of hepatitis C, and because most prisoners will eventually return to our communities, successful treatment options in the criminal justice system could have a tremendous impact on public health at large (Figs. 1, 2, 3, and 4).…”

Section: Hepatitis Cmentioning

confidence: 99%

The Need for Higher Standards in Correctional Healthcare to Improve Public Health

2014

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Diagnosis, management, and treatment of hepatitis C: An update # † ‡

Cited by 2,722 publications

References 432 publications

Evaluation of liver disease progression in the German hepatitis C virus (1b)-contaminated anti-D cohort at 35 years after infection

Evaluation of liver disease progression in the German hepatitis C virus (1b)-contaminated anti-D cohort at 35 years after infection

Ombitasvir/Paritaprevir/Ritonavir With or Without Dasabuvir and With or Without Ribavirin for Adolescents With HCV Genotype 1 or 4

The Need for Higher Standards in Correctional Healthcare to Improve Public Health

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