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Article: Hepatitis C treatment: where are we now?

Burstow, Nicholas J / Mohamed, Zameer / Gomaa, Asmaa I / Sonderup, Mark W / Cook, Nicola A / Waked, Imam / Spearman, C Wendy / Taylor-Robinson, Simon D

International journal of general medicine

2017 Volume 10, Page(s) 39–52

Abstract: Chronic hepatitis C infection affects millions of people worldwide and confers significant ... of hepatitis C. ... morbidity and mortality. Effective treatment is needed to prevent disease progression and associated ...

Abstract	Chronic hepatitis C infection affects millions of people worldwide and confers significant morbidity and mortality. Effective treatment is needed to prevent disease progression and associated complications. Previous treatment options were limited to interferon and ribavirin (RBV) regimens, which gave low cure rates and were associated with unpleasant side effects. The era of direct-acting antiviral (DAA) therapies began with the development of first-generation NS3/4A protease inhibitors in 2011. They vastly improved outcomes for patients, particularly those with genotype 1 infection, the most prevalent genotype globally. Since then, a multitude of DAAs have been licensed for use, and outcomes for patients have improved further, with fewer side effects and cure rates approaching 100%. Recent regimens are interferon-free, and in many cases, RBV-free, and involve a combination of DAA agents. This review summarizes the treatment options currently available and discusses potential barriers that may delay the global eradication of hepatitis C.
Language	English
Publishing date	2017-02-17
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2452220-X
ISSN	1178-7074
ISSN	1178-7074
DOI	10.2147/IJGM.S127689
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Article: Treatment of patients with hepatitis C virus genotype 3: Where are we now?

Landaverde, Carmen / Wells, Jennifer T / Gutierrez, Julio / Poordad, Fred

Clinical liver disease

2015 Volume 6, Issue 4, Page(s) 79–81

Language	English
Publishing date	2015-10-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2657644-2
ISSN	2046-2484
ISSN	2046-2484
DOI	10.1002/cld.506
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Article: Liver Disease: Hepatitis C.

St Louis, Joshua / Baumgartner, Katrina / Cooper, Julia / Smith, Andrew

FP essentials

2021 Volume 511, Page(s) 23–28

Abstract: ... not received hepatitis C treatment previously are eligible for primary care-based treatment ... provide treatment for most patients. Adults with chronic hepatitis C who do not have cirrhosis and have ... Management of hepatitis C has simplified significantly, and primary care physicians now can monitor and ...

Abstract	Approximately 4.1 million individuals in the United States have a history of hepatitis C virus (HCV) exposure, including 2.5 million with chronic infection. Screening guidelines recommend one-time, routine, opt out HCV screening for all individuals 18 years or older. Risk-based testing is recommended for specific individuals. Although many patients with chronic hepatitis C may progress to cirrhosis, end-stage liver disease, and hepatocellular carcinoma, early treatment can prevent development of these sequelae. Management of hepatitis C has simplified significantly, and primary care physicians now can monitor and provide treatment for most patients. Adults with chronic hepatitis C who do not have cirrhosis and have not received hepatitis C treatment previously are eligible for primary care-based treatment. These patients should undergo a comprehensive pretreatment evaluation to guide treatment planning. Patients typically are treated with one of two pangenotypic regimens: glecaprevir-pibrentasvir for 8 weeks or sofosbuvir-velpatasvir for 12 weeks. Virologic cure, defined as sustained virologic response (SVR) at 12 weeks after treatment completion, should be confirmed by an undetectable quantitative HCV RNA via polymerase chain reaction test performed 12 weeks or later after treatment completion. Management results in rates of virologic cure of greater than 95% across genotypes. Patients who do not achieve SVR at 12 weeks should be referred to a subspecialist experienced in management of treatment failure.
MeSH term(s)	Antiviral Agents/therapeutic use ; Drug Combinations ; Hepacivirus/genetics ; Hepatitis C/drug therapy ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Humans ; Liver Cirrhosis/diagnosis ; Persistent Infection ; Treatment Outcome
Chemical Substances	Antiviral Agents ; Drug Combinations
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Journal Article
ISSN	2159-3000
ISSN	2159-3000
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Article ; Online: Milestones in the discovery of hepatitis C.

Campollo, Octavio / Amaya, Gerardo / McCormick, P Aiden

World journal of gastroenterology

2022 Volume 28, Issue 37, Page(s) 5395–5402

Abstract: ... of three researchers, Alter H, Houghton M and Rice C, which set the basis for the diagnosis, treatment and ... the direct acting antivirals, which are now used not only to cure the disease but most probably, to eliminate ... The discovery of hepatitis C has been a landmark in public health as it brought the opportunity ...

Abstract	The discovery of hepatitis C has been a landmark in public health as it brought the opportunity to save millions of lives through the diagnosis, prevention and cure of the disease. The combined work of three researchers, Alter H, Houghton M and Rice C, which set the basis for the diagnosis, treatment and prevention of hepatitis C apart from laying the ground work for a new approach to study infections in general and developing new antiviral agents. This is a story of a transfusion-associated infection. A series of clinical studies demonstrated the existence of an infectious agent associated with hepatitis. That was followed by the identification of what was later known to be the hepatitis C virus (HCV) and the development of diagnostic tests. It all preceded the full molecular identification and demonstration of a causal effect. Finally it ended up with the development and discovery of a new class of therapeutic drugs, the direct acting antivirals, which are now used not only to cure the disease but most probably, to eliminate the problem. This work started with Dr Alter H who demonstrated that a new virus was responsible for the majority of post-transfusion hepatitis followed by Houghton M who cloned the virus and developed the blood test to identify those cases that carried the virus. Finally, the work of Rice C demonstrated that a cloned HCV produced after applying molecular biology techniques could cause long-standing infection and cause the same disease as the one observed in humans.
MeSH term(s)	Humans ; Hepacivirus/genetics ; Antiviral Agents/therapeutic use ; Hepatitis C, Chronic/drug therapy ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Blood Transfusion
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2022-10-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v28.i37.5395
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Article: Hepatitis B virus genotypes in precision medicine of hepatitis B-related hepatocellular carcinoma: Where we are now.

Sukowati, Caecilia H C / Jayanti, Sri / Turyadi, Turyadi / Muljono, David H / Tiribelli, Claudio

World journal of gastrointestinal oncology

2024 Volume 16, Issue 4, Page(s) 1097–1103

Abstract: Hepatitis B virus (HBV) infection is a major player in chronic hepatitis B that may lead ... to the development of hepatocellular carcinoma (HCC). HBV genetics are diverse where it is classified into at least 9 ... for HBV-related HCC and the success of therapeutical approaches against HCC, related to different ...

Abstract	Hepatitis B virus (HBV) infection is a major player in chronic hepatitis B that may lead to the development of hepatocellular carcinoma (HCC). HBV genetics are diverse where it is classified into at least 9 genotypes (A to I) and 1 putative genotype (J), each with specific geographical distribution and possible different clinical outcomes in the patient. This diversity may be associated with the precision medicine for HBV-related HCC and the success of therapeutical approaches against HCC, related to different pathogenicity of the virus and host response. This Editorial discusses recent updates on whether the classification of HBV genetic diversity is still valid in terms of viral oncogenicity to the HCC and its precision medicine, in addition to the recent advances in cellular and molecular biology technologies.
Language	English
Publishing date	2024-04-05
Publishing country	China
Document type	Editorial
ZDB-ID	2573696-6
ISSN	1948-5204
ISSN	1948-5204
DOI	10.4251/wjgo.v16.i4.1097
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Article ; Online: Therapeutic Advances in Viral Hepatitis A-E.

Nagra, Navroop / Kozarek, Richard A / Burman, Blaire E

Advances in therapy

2022 Volume 39, Issue 4, Page(s) 1524–1552

Abstract: ... affected. We now, remarkably, have highly effective curative regimens for hepatitis C, and safe and ... end-stage-liver disease, and liver cancer. Viral hepatitis occurs worldwide, though certain regions are disproportionately ... available preventive and curative strategies are needed to achieve global eradication of viral hepatitis ...

Abstract	Viral hepatitis remains a significant global health problem. All forms of viral hepatitis A through E (A-E) can lead to acute symptomatic infection, while hepatitis B and C can lead to chronic infection associated with significant morbidity and mortality related to progression to cirrhosis, end-stage-liver disease, and liver cancer. Viral hepatitis occurs worldwide, though certain regions are disproportionately affected. We now, remarkably, have highly effective curative regimens for hepatitis C, and safe and tolerable medications to suppress hepatitis B activity, and to prevent liver damage and slow disease progression. We have effective vaccines for hepatitis A and B which provide long-lasting immunity, while improved sanitation and awareness can curb outbreaks of hepatitis A and E. However, more effective and available preventive and curative strategies are needed to achieve global eradication of viral hepatitis. This review provides an overview of the epidemiology, transmission, diagnosis, and clinical features of each viral hepatitis with a primary focus on current and future therapeutic and curative options.
MeSH term(s)	Antiviral Agents/therapeutic use ; Hepatitis A/epidemiology ; Hepatitis A/prevention & control ; Hepatitis B/diagnosis ; Hepatitis B/drug therapy ; Hepatitis B/prevention & control ; Hepatitis, Viral, Human/drug therapy ; Hepatitis, Viral, Human/epidemiology ; Hepatitis, Viral, Human/prevention & control ; Humans ; Liver Neoplasms/drug therapy
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2022-02-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-022-02070-z
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Zs.A 2101: Show issues

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Article ; Online: Fibrosis reversal after hepatitis C virus elimination.

Rockey, Don C

Current opinion in gastroenterology

2019 Volume 35, Issue 3, Page(s) 137–144

Abstract: ... antiviral (DAA) drugs, cure rates are now almost 100%. With this explosion of effective therapy, it is ... Purpose of review: Hepatitis C virus (HCV) infection has been the leading cause of cirrhosis ... in the United States now for the last several decades. With the introduction of highly effective direct acting ...

Abstract	Purpose of review: Hepatitis C virus (HCV) infection has been the leading cause of cirrhosis in the United States now for the last several decades. With the introduction of highly effective direct acting antiviral (DAA) drugs, cure rates are now almost 100%. With this explosion of effective therapy, it is possible that many patients with HCV may have reversion in fibrosis. The purpose of this review is, therefore, to report on recent findings in this field. Recent findings: Older data that examined the effect of interferon-based HCV therapy indicate that fibrosis reverses after HCV eradication. More recent work in the DAA era similarly indicates that fibrosis is reversible. A caveat is that DAA therapy causes rapid viral clearance, and appears to lead to rapid reductions in inflammation. Some tools (such as transient elastography), which may also reflect the inflammatory response, and thus may 'overestimate' of fibrosis reversal. However, emerging data suggesting improved outcomes in patients with cirrhosis after HCV clearance support the concept that even cirrhosis reverses in some patients. Summary: Fibrosis (and cirrhosis) reversion, to some extent, occurs after HCV clearance. This topic is vitally important and information continues to emerge; more data on this subject are expected and needed.
MeSH term(s)	Antiviral Agents/therapeutic use ; Cytokines/immunology ; Elasticity Imaging Techniques ; Hepatic Stellate Cells/immunology ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/immunology ; Humans ; Inflammation/immunology ; Liver Cirrhosis/diagnostic imaging ; Liver Cirrhosis/drug therapy ; Liver Cirrhosis/etiology ; Liver Cirrhosis/immunology ; Remission Induction
Chemical Substances	Antiviral Agents ; Cytokines
Language	English
Publishing date	2019-03-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	632571-3
ISSN	1531-7056 ; 0267-1379
ISSN (online)	1531-7056
ISSN	0267-1379
DOI	10.1097/MOG.0000000000000524
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Zs.A 2072: Show issues

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Article ; Online: Forecasting Hepatitis C Virus Status for Children in the United States: A Modeling Study.

Hood, Robert B / Norris, Alison H / Shoben, Abigail / Miller, William C / Harris, Randall E / Pomeroy, Laura W

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2024

Abstract: ... options are now available for children ≥3 years old. Reducing HCV infections in adults could decrease HCV ... vertically infected with HCV. Infection has long-term consequences for a child's health, but treatment ... direct-acting antiviral treatment for children forecasted that the number of acutely infected children ...

Abstract	Background: Virtually all cases of hepatitis C virus (HCV) infection in children in the United States occur through vertical transmission, but it is unknown how many children are infected. Cases of maternal HCV infection have increased in the United States, which may increase the number of children vertically infected with HCV. Infection has long-term consequences for a child's health, but treatment options are now available for children ≥3 years old. Reducing HCV infections in adults could decrease HCV infections in children. Methods: Using a stochastic compartmental model, we forecasted incidence of HCV infections in children in the United States from 2022 through 2027. The model considered vertical transmission to children <13 years old and horizontal transmission among individuals 13-49 years old. We obtained model parameters and initial conditions from the literature and the Centers for Disease Control and Prevention's 2021 Viral Hepatitis Surveillance Report. Results: Model simulations assuming direct-acting antiviral treatment for children forecasted that the number of acutely infected children would decrease slightly and the number of chronically infected children would decrease even more. Alone, treatment and early screening in individuals 13-49 years old reduced the number of forecasted cases in children and, together, these policy interventions were even more effective. Conclusions: Based on our simulations, acute and chronic cases of HCV infection are remaining constant or slightly decreasing in the United States. Improving early screening and increasing access to treatment in adults may be an effective strategy for reducing the number of HCV infected children in the United States.
Language	English
Publishing date	2024-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciae157
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Article ; Online: Management of Hepatitis C in Children - A New Paradigm.

Poddar, Ujjal / Umesh Reddy, D V

Indian pediatrics

2023 Volume 60, Issue 1, Page(s) 55–62

Abstract: ... a paradigm shift in the management of hepatitis C (HCV) infection in children. In this review, we summarize ... the various treatment options for pediatric HCV infection, highlighting the recent changes in the management ... for children above three years of age, the treatment of active HCV infection (HCV-RNA positive) in children has ...

Abstract	Introduction: With the advent of direct-acting antivirals (DAAs), the past decade has seen a paradigm shift in the management of hepatitis C (HCV) infection in children. In this review, we summarize the various treatment options for pediatric HCV infection, highlighting the recent changes in the management. Methods: A literature search was performed using the PubMed database with the relevant keywords. Filters included were human, ages 0-18 years, and the English language. Results: Initial phase of HCV treatment using conventional or pegylated interferon and ribavirin combination regimens yielded poor outcomes in children, especially in genotypes 1 and 4, with an overall sustained virologic response of 58%. Also, treatment with interferon and ribavirin combination was associated with significant side effects in up to 52% of those treated. Presently, various combinations of direct-acting antivirals (DAAs) have been approved in children above three years of age with documented evidence of high efficacy (SVR12 of 92% to 100%) and excellent safety, and the current standard of care. Conclusion: With various DAA regimens now being approved for children above three years of age, the treatment of active HCV infection (HCV-RNA positive) in children has become simple. Besides the effectiveness of DAA therapy, public awareness about HCV transmission, better screening, and making the DAAs available at a subsidized price in the public sectors are necessary to eliminate HCV infection in India.
MeSH term(s)	Humans ; Child ; Infant, Newborn ; Infant ; Child, Preschool ; Adolescent ; Ribavirin/therapeutic use ; Antiviral Agents/therapeutic use ; Hepatitis C, Chronic/drug therapy ; Drug Therapy, Combination ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Hepatitis C/chemically induced ; Interferons/therapeutic use ; Genotype ; Treatment Outcome
Chemical Substances	Ribavirin (49717AWG6K) ; Antiviral Agents ; Interferons (9008-11-1)
Language	English
Publishing date	2023-01-13
Publishing country	India
Document type	Review ; Journal Article ; Comment
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Zs.A 859: Show issues

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Article ; Online: Hepatocellular Carcinoma Prevention in the Era of Hepatitis C Elimination.

Lazarus, Jeffrey V / Picchio, Camila A / Colombo, Massimo

International journal of molecular sciences

2023 Volume 24, Issue 18

Abstract: ... of the infection is now possible in almost all treated patients, leading to a significant reduction but not ... to eliminate hepatitis C as a global health threat, as set out by the World Health Organization, an integrated ... prevention of HCV transmission, and treatment of HCV with safe and efficacious direct antiviral agents (DAAs ...

Abstract	The hepatitis C virus (HCV), a single-stranded RNA virus belonging to the Flaviviridae family, is a major cause of hepatocellular carcinoma (HCC) worldwide. Tumors caused by HCC have an increased mortality rate globally, which is more accentuated in Western countries. The carcinogenic potential of this virus is mediated through a wide range of mechanisms, spanning from the induction of chronic inflammation to oxidative stress and deregulation of cellular pathways by viral proteins. As the number of new infections continues unabated, HCC-related mortality should be prioritized through early detection, continued prevention of HCV transmission, and treatment of HCV with safe and efficacious direct antiviral agents (DAAs). People who inject drugs (PWID) are a significant reservoir of new HCV infections globally, and in order to eliminate hepatitis C as a global health threat, as set out by the World Health Organization, an integrated approach based on the optimization of care delivery and increased access to harm reduction and treatment for PWID is needed. Thanks to the development of safe and effective antiviral agents, eradication of the infection is now possible in almost all treated patients, leading to a significant reduction but not the elimination of the risk for HCC in cured patients. This is particularly relevant among aged populations who have cofactors of morbidity known to accelerate HCC progression, such as diabetes, obesity, and excessive alcohol consumption. Given the restless accumulation of individuals with cured HCV infection, the implementation of risk-stratified surveillance programs becomes impellent from a cost-effectiveness perspective, whereas the availability of a performant biomarker to predict HCC in cured patients remains an unmet clinical need.
MeSH term(s)	Humans ; Aged ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/prevention & control ; Hepacivirus ; Substance Abuse, Intravenous/complications ; Substance Abuse, Intravenous/drug therapy ; Liver Neoplasms/etiology ; Liver Neoplasms/prevention & control ; Liver Neoplasms/diagnosis ; Hepatitis C/complications ; Hepatitis C/drug therapy ; Hepatitis C/prevention & control ; Antiviral Agents/pharmacology ; Hepatitis C, Chronic/complications ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/prevention & control
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2023-09-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms241814404
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