June 2011 Full Text ; Chronic Hepatitis C

View On Blog;
2011Chronic Hepatitis C-Full Text

Full Text ; Or download Chronic Hepatitis C
Jae Young Jang* and Raymond T. Chung†
From;
Gut and Liver 2011 Jun; 5(2): 117-132

Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea, †Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, MA, USA

Data Covered;
FACTORS IMPACTING TREATMENT RESPONSE
TREATMENT CANDIDATES
DEFINITION OF VIRAL RESPONSE PATTERNS AND
ASSOCIATED SVR
IMPACT OF TREATMENT
NEW TREATMENTS FOR CHRONIC HEPATITIS C
SCREENING FOR HEPATOCELLULAR CARCINOMA

Goals of treatment
Response-guided therapy
Breakthrough and relapse
IL28B genotype,a powerful host factor in determining IFN responsiveness
HIV/HCV coinfection

The goal of antiviral therapy for patients with chronic hepatitis C virus (HCV) infection is to attain a sustained virologic response (SVR), which is defined as undetectable serum HCV-RNA levels at 6 months after the cessation of treatment. Major improvements in antiviral therapy for chronic hepatitis C have occurred in the past decade. The addition of ribavirin to interferon-alfa therapy and the introduction of pegylated interferon (PEG-IFN) have substantially improved SVR rates in patients with chronic hepatitis C.

The optimization of HCV therapy with PEG-IFN and ribavirin continues to evolve. Studies are ongoing that use viral kinetics to tailor therapy to an individual' antiviral response and determine the ideal length of treatment to maximize the chance of SVR.

Improved SVR can be achieved with new specifi c inhibitors that target the HCV NS3/4A protease and the NS5B polymerase. Several long-term follow-up studies have shown that SVR, when achieved, is associated with a very low risk of virologic relapse. Furthermore, antiviral therapy can reduce the morbidity and mortality rates associated with chronic hepatitis C by reducing fi brosis progression, the incidence of cirrhosis, and hepatocellular carcinoma. (Gut Liver 2011;5:117-132)

Click Here To; Download PDF

'
.