Sustained Virologic Response and Clinical Outcomes in Patients with Chronic Hepatitis C and Advanced Fibrosis

Veldt, Bart J.; Heathcote, E. Jenny; Wedemeyer, Heiner; Reichen, Juerg; Hofmann, Wolf Peter; Zeuzem, Stefan; Manns, Michael P.; Hansen, Bettina E.; Schalm, Solko W.; Janssen, Harry L.A.

doi:10.7326/0003-4819-147-10-200711200-00003

Cited by 554 publications

(416 citation statements)

References 26 publications

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“…The authors found that SVR was associated 18 ( with a statistically significant reduction in the hazard of clinical events, mainly liver failure. 12 In a retrospective study from the United Kingdom, patients with advanced liver fibrosis who underwent a liver biopsy before 2002 were followed for a median of 51 months. Of the 131 patients with no previous history of decompensated disease, 25% died or received a transplant after a median interval of 42 months.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 For this reason, all HIVinfected individuals with positive HCV RNA determinations should be considered as candidates for anti-HCVtreatment, providing HIV infection is wellcontrolled and there are no contraindications to therapy with interferon or ribavirin. [7][8][9][10] It is known that response to antiviral therapy appears to reduce liver complications in chronic hepatitis C 11,12 ; however, little is known about the clinical consequences of achieving a sustained virological response (SVR) following therapy with interferon plus ribavirin in coinfected patients. Our objective was to determine the effect of achieving an SVR on clinical outcomes including mortality and liver-related complications in patients coinfected with HIV/HCV.…”

Section: H Uman Immunodeficiency Virus (Hiv) Infectionmentioning

confidence: 99%

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Sustained virological response to interferon plus ribavirin reduces liver‐related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus†

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: H Uman Immunodeficiency Virus (Hiv) Infectionmentioning

confidence: 99%

Sustained virological response to interferon plus ribavirin reduces liver‐related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus†

et al. 2009

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“…Sur le plan hépatique et en l'absence de comorbidité, la fibrose va se remodeler et, ainsi, la RVP permettra une réparation progressive du foie. La meilleure illustration en est la réduc-tion significative de la mortalité hépatique (notamment par complication des cirrhoses incluant le CHC) chez les patients guéris par rapport aux autres patients [8]. Ceci est particulièrement observé chez les sujets ayant initialement une cirrhose.…”

Section: Le Traitement De L'infection Par Le Virus De L'hépatite C Hiunclassified

Virus de l’hépatite C

Pol

2013

Med Sci (Paris)

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> Le traitement de l'infection chronique par le virus de l'hépatite C (VHC) a singulièrement progressé ces deux dernières décennies. Depuis 15 ans environ, la combinaison de l'interféron  pégylé et de la ribavirine permet d'obtenir un taux de réponse virologique prolongée, assimilable à une guérison, chez 45 % des patients infectés par un génotype 1, 65 % de ceux infectés par un génotype 4, 70 % de ceux infectés par un génotype 3 et environ 85 % de ceux infectés par un génotype 2. Une meilleure compréhension du cycle réplicatif du VHC a permis le développement d'antiviraux directs spécifiques du virus ciblant les protéines virales (la protéase NS [non structural] 3/4A, la polymérase NS5B avec des inhibiteurs nucléosidiques et non nucléosidiques, la protéine multifonctionnelle NS5A du complexe de replication). De nombreux résultats ont montré que des combinaisons d'inhibiteurs de première génération, notamment les inhibiteurs de protéases, en association avec l'interféron pégylé et la ribavirine, avaient une efficacité antivirale élevée (75 % de guérison des patients infectés par un VHC de génotype 1) avec une tolérance difficile. Cette première étape majeure a été rapidement suivie de l'utilisation d'une combinaison des antiviraux directs de deuxième génération avec l'interféron pégylé et la ribavirine, permettant d'augmenter sensiblement les taux de guérison (de 75 à 90 %) avec une réduction des durées de traitement et du nombre de comprimés administrés. La prochaine étape sera la combinaison des antiviraux directs, qui deviendra le standard de traitement en 2015. La plupart des études ont inclus des patients « faciles à traiter », en petit nombre, avec des résultats d'efficacité et de tolérance remarquables. Cependant, les résultats obtenus avec les « populations difficiles à traiter » (sujets en échec de traitements antérieurs, notamment par les inhibiteurs de protéases, sujets cirrhotiques, sujets transplantés hépatiques ou rénaux, et sujets infectés par le VIH [virus de l'immunodéficience humaine]) restent à confirmer et sont impatiemment attendus. < . La véritable révolution thérapeutique à laquelle on assiste aujourd'hui est probablement unique, à plus d'un titre. L'infection par le VHC est la seule infection chronique dont on guérit. La rapidité de développement de nouveaux traitements, constamment plus efficaces et mieux tolérés, est sans doute sans comparaison dans l'histoire pharmaceutique. Les capacités de remodelage et de régé-nération hépatiques, permettent potentiellement, avec la guérison virale, la réparation des lésions, notamment de fibrose, générées lors de l'infection. S'ouvrent ainsi de nouveaux défis pour un dépistage plus large, un accès facilité aux traitements les plus efficaces, et une réflexion sociétale sur le rapport coût/efficacité des stratégies diagnostiques et thérapeutiques. Sur cette thématique clinique et de recherche, la France a été et reste dans le trio de tête depuis ces deux dernières décennies. Cette revue résume cette courte histoire exemplaire et récente. Épidémiolog...

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“…In a multicenter retrospective study of 479 HCV patients treated with IFN or PEG-IFN with or without ribavirin, 142 (29.6%) subjects had a sustained response (74). The HR for HCC in sustained responders was 0.46 (95% CI, 0.12-1.70), P=0.25 compared to those who did not have a sustained response.…”

Section: Hcc In Patients Treated With Ifn Based Therapymentioning

confidence: 99%

“…Studies demonstrate that the risk of HCC in individuals who achieve virologic cure is reduced compared to nonresponders (74)(75)(76)(77)(78). In a multicenter retrospective study of 479 HCV patients treated with IFN or PEG-IFN with or without ribavirin, 142 (29.6%) subjects had a sustained response (74).…”

Section: Hcc In Patients Treated With Ifn Based Therapymentioning

confidence: 99%

Viral hepatitis and hepatocellular carcinoma: etiology and management

Zamor

deLemos

Russo

2017

J. Gastrointest. Oncol.

128

102

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Hepatitis B virus (HBV) risk and hepatocellular carcinoma (HCC) EpidemiologyIt is estimated that over 50% of HCC cases worldwide are related to chronic HBV (1,2). Since the implementation of worldwide HBV vaccination there has been an overall decline in the burden of HBV, yet the HBV burden remains quite high in various parts of the world. There are approximately 350-400 million people across the world infected with HBV, the majority reside in or originate from Asia. Each year HBV accounts for 749,000 new cases of HCC and 692,000 HCC-related deaths (3). The annual incidence of HCC is estimated to be <1% for non-cirrhotic HBV infected patients and 2-3% for those with cirrhosis. Because of worldwide and geographic variations in HBV incidence, the burden of HBV related HCC also varies. Asian-Pacific and sub-Saharan Africa represent the highest incidence of HCC worldwide. Much lower risk of HBV associated HCC is seen in the United States with less than 20% incidence. Due to its diversity, Europe has different areas: low risk (18%) in West and North and high risk (51%) East and South (4). Occult HBV or subclinical infection as defined by detectable HBV DNA in the liver but hepatitis B surface antigen (HBsAg) seronegativity is now recognized as increased risk for HCC. The risk is most notable in those over the age of 50 (5,6). Recently published data reveal that in China, the age-standardized death due to HBV-related HCC and cirrhosis in 2013 was 10.95 and 4.91 per 100,000 people (7). Fifty-five percent of all HCC cases worldwide are reported from China (8).In 1991, the WHO recommended the integration of the HBV vaccine into national immunization programs in countries with an HBV carrier prevalence of 8% or higher by 1995 and in all other countries by 1997 (9). The universal infant vaccination rate in sub-Saharan Africa was initially quite low at 5% in 2000 but increased to 72% by 2012. Parts of the Pacific region had the lowest immunization rates, but by 2012 had increased to the highest rates at 91%. Taiwan has an exceptionally higher This review outlines the various mechanisms and pathophysiology that contributes to this process. There will also be a review on the recommended screening for HCC. Treatment considerations, which are different for these viruses, will be outlined in this review.

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Sustained Virologic Response and Clinical Outcomes in Patients with Chronic Hepatitis C and Advanced Fibrosis

Abstract: Sustained virologic response to treatment is associated with improved clinical outcomes, mainly prevention of liver failure, in patients with chronic hepatitis C and advanced fibrosis.

Cited by 554 publications

References 26 publications

Sustained virological response to interferon plus ribavirin reduces liver‐related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus†

Sustained virological response to interferon plus ribavirin reduces liver‐related complications and mortality in patients coinfected with human immunodeficiency virus and hepatitis C virus†

Virus de l’hépatite C

Viral hepatitis and hepatocellular carcinoma: etiology and management

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