Treatment of viral hepatitis: a new era

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Special Issue: Proceedings of the 6th Paris Hepatitis Conference, International Conference on the Management of Patients with Viral Hepatitis

February 2013

Volume 33, Issue Supplements1 Pages 1–199

We are pleased to present the supplement for the 6th Paris Hepatitis Conference (PHC). This supplement of Liver International includes review articles with the most up-to-date information on the clinical care of patients with hepatitis B and hepatitis C, which was presented at this meeting.

Review Articles

 

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   Optimal treatment with telaprevir for chronic HCV infection (pages 3–13)Arun B. Jesudian and Ira M. Jacobson
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12079
   

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   Optimal treatment with boceprevir for chronic HCV infection (pages 14–22)Benjamin Maasoumy and Michael P. Manns
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12070
   

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   How to optimize HCV therapy in genotype 1 patients: predictors of response (pages 23–29)Salvatore Petta and Antonio Craxì
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12053
   

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   How to optimize HCV therapy in genotype 1 patients: management of side-effects (pages 30–34)Angeli Chopra, Patricia L. Klein, Thia Drinnan and Samuel S. Lee
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12080
   

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   How to optimize HCV therapy in genotype 2 patients (pages 35–40)Eleonora Grassi and Alessio Aghemo
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12056
   

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   How to optimize HCV therapy in genotype 4 patients (pages 41–45)Gamal Esmat, Mohamed El Kassas, Mohamed Hassany, Mohamed Esmat Gamil and Maisa El Raziky
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12059
   

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   How to optimize HCV therapy in genotype 1 patients with cirrhosis (pages 46–55)Marc Bourlière, Astrid Wendt, Hélène Fontaine, Christophe Hézode, Stanislas Pol and Jean Pierre Bronowicki
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12067
   

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   Current management and perspectives for HCV recurrence after liver transplantation (pages 56–62)Audrey Coilly, Bruno Roche and Didier Samuel
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12062
   

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   HCV therapy in HIV-infected patients (pages 63–67)Mark S. Sulkowski
   Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12082
   

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    Best strategies for global HCV eradication (pages 68–79)Liesl M. Hagan and Raymond F. Schinazi
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12063
    

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    New therapeutic strategies in HCV: second-generation protease inhibitors (pages 80–84)Virginia C. Clark, Joy A. Peter and David R. Nelson
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12061
    

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    New therapeutic strategies in HCV: polymerase inhibitors (pages 85–92)Ludmila Gerber, Tania M. Welzel and Stefan Zeuzem
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12068
    

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    Interferon free therapy with direct acting antivirals for HCV (pages 93–104)Tarik Asselah and Patrick Marcellin
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12076
    

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    Patients with HCV and F1 and F2 fibrosis stage: treat now or wait? (pages 105–110)Mitchell L. Shiffman and Yves Benhamou
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12066
    

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    Impact of therapy on the outcome of chronic hepatitis B (pages 111–115)Yun-Fan Liaw
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12057
    

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    Optimal management of chronic hepatitis B patients with treatment failure and antiviral drug resistance (pages 116–124)Fabien Zoulim and Stephen Locarnini
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12069
    

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    The role of HBsAg quantification for monitoring natural history and treatment outcome (pages 125–132)Michelle Martinot-Peignoux, Martine Lapalus, Tarik Asselah and Patrick Marcellin
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12075
    

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    Why do I treat HBeAg-positive chronic hepatitis B patients with a Nucleoside analogue (pages 133–136)Hong Ma and Jidong Jia
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12065
    

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    Treatment of HBeAg positive chronic hepatitis B: interferon or nucleoside analogues (pages 137–150)Geoffrey Dusheiko
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12078
    

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    Why do I treat HBeAg-negative chronic hepatitis B patients with nucleos(t)ide analogues? (pages 151–156)George V. Papatheodoridis
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12054
    

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    Why do I treat HBeAg-negative chronic hepatitis B patients with pegylated interferon? (pages 157–163)Pietro Lampertico, Mauro Viganò and Massimo Colombo
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12064
    

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    Management of acute hepatitis B and reactivation of hepatitis B (pages 164–175)Ankur Jindal, Manoj Kumar and Shiv K. Sarin
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12081
    

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    Treatment of HBV related cirrhosis (pages 176–181)Florian van Bömmel and Thomas Berg
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12074
    

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    Management of HBV in immunocompromised patients (pages 182–187)Stanislas Pol
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12055
    

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    Optimal management of HBV infection during pregnancy (pages 188–194)Teerha Piratvisuth
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12060
    

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    Current management of delta hepatitis (pages 195–197)Mario Rizzetto
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12058
    

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    Hope for the eradication of HCV worldwide (pages 198–199)Jean-François Delfraissy
    Article first published online: 3 JAN 2013 | DOI: 10.1111/liv.12077
    

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Treatment of viral hepatitis: a new era

Patrick Marcellin, Tarik Asselah

Article first published online: 3 JAN 2013

DOI: 10.1111/liv.12086

Dear Colleagues,

We are pleased to present the supplement for the 6th Paris Hepatitis Conference (PHC). This supplement of Liver International includes review articles with the most up-to-date information on the clinical care of patients with hepatitis B and hepatitis C, which was presented at this meeting.

This meeting will once again provide state of the art information on the management of patients with hepatitis B and hepatitis C by outstanding international experts who will present the most recent data as well as the clinical applications in this area. The PHC 2013 includes a full day dedicated to hepatitis C and a full day dedicated to hepatitis B. Approximately, 170 million people have been infected with HCV worldwide. There are about 350 million carriers of HBV.
 

The goal of the PHC is to encourage interaction with the audience during the plenary sessions (round table discussions). In addition, several interactive luncheons are held every day for discussions between experts and participants. Since the first edition of the meeting in 2004, attendance has steadily increased. More than 1000 specialists (most of them key national opinion leaders) from more than 60 countries and all continents have participated in this year's PHC meeting. Rapid progress, the availability of many new drugs and new therapeutic strategies are increasing the complexity and individualizing the management of patients with viral hepatitis. Therefore it is extremely important to educate and advise clinicians, so that available information can be exploited to optimize management of these patients.
 

Last year, the meeting was specifically devoted to hepatitis C and the recent spectacular innovations made in the management of this disease thanks to the development of new therapies. At present, the treatment for hepatitis C virus (HCV) genotype 1 chronic infection is the combination of direct-acting antivirals (DAA) with a protease inhibitor (telaprevir or boceprevir) with the pegylated interferon (PEG-IFN) plus ribavirin (RBV) regimen [1-3]. The primary goal of treatment is to achieve a sustained virological response (SVR), which is usually defined as undetectable serum or plasma HCV RNA 24 weeks after the end of treatment. A SVR corresponds to a cure [4]. Twelve weeks post-treatment follow-up appears to be as relevant as 24 weeks to determine SVR [5]. Some IFN-stimulated genes have been shown to be highly expressed in non-responders; thus, pre-activation of the IFN system in patients appears to limit the effect of IFN antiviral therapy [6, 7].
 

Hopefully, second-generation protease inhibitors (simeprevir and faldaprevir) once a day will soon be available with PEG-IFN and RBV, making treatment easier. Thus, DAA with different viral targets, including NS3 protease inhibitors, nucleoside/nucleotide analogues and non-nucleoside inhibitors of the RNA-dependent RNA polymerase, and NS5A inhibitors are under development [8-10]. Early data have demonstrated that antiviral combinations with additive potency that lack cross-resistance and have a good safety profile may provide new regimens in the near future to make HCV the first chronic viral infection eradicated worldwide with a finite duration of combination DAA therapy without IFN [8]. Thus, clinicians have turned their attention to an exciting new direction: finding interferon-free therapy that will be effective in all genotypes. This raises an important issue that will be at the heart of discussions during the PHC conference in 2013: which patients should be treated in 2013 and how can we increase their chance of a cure? Which patients can be treated later based on future options?
 

At the same time, the PHC 2013 conference, as in the past, will address and focus upon Hepatitis B. We will spend a full day discussing results on the long-term outcome of patients receiving the most potent available antiviral drugs. We will also assess the issue of quantifying HBsAg and its role as a new tool for predicting the severity of disease and response to therapy. The optimal management of special populations and difficult situations will be extensively discussed: pregnancy, co-infections, cirrhosis. As in previous PHCs, we will privilege interactive discussions and many specific working luncheons addressing the management of real-life patients. Finally, the ultimate goal of PHC 2013 is to review the most current knowledge and discuss their therapeutic applications with the most experienced experts to provide optimal therapy and the best chance of cure to as many patients as possible, worldwide.
 

All the reviews from these outstanding international experts have been published in this issue of Liver International, which is available during the meeting. This up-to-date issue covers every aspect of hepatitis C and hepatitis B management.

References

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2. References

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• 2
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  EASL. EASL Clinical Practice Guidelines: management of hepatitis C virus infection. J Hepatol 2011; 2: 245–64.
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  Maylin S, Martinot-Peignoux M, Moucari R, et al. Eradication of hepatitis C virus in patients successfully treated for chronic hepatitis C. Gastroenterology 2008; 3: 821–9.
• 5
  Martinot-Peignoux M, Stern C, Maylin S, et al. Twelve weeks posttreatment follow-up is as relevant as 24 weeks to determine the sustained virologic response in patients with hepatitis C virus receiving pegylated interferon and ribavirin. Hepatology 2010; 4: 1122–6.
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  Sarasin-Filipowicz M, Oakeley EJ, Duong FH, et al. Interferon signaling and treatment outcome in chronic hepatitis C. Proc Natl Acad Sci USA 2008; 19: 7034–9.
• 7
  Asselah T, Bieche I, Narguet S, et al. Liver gene expression signature to predict response to pegylated interferon plus ribavirin combination therapy in patients with chronic hepatitis C. Gut 2008; 4: 516–24.
• 8
  Asselah T, Marcellin P. Direct acting antivirals for the treatment of chronic hepatitis C: one pill a day for tomorrow. Liver Int 2012; 32 (Suppl 1): 88–102.
• 9
  Lok AS, Gardiner DF, Lawitz E, et al. Preliminary study of two antiviral agents for hepatitis C genotype 1. N Engl J Med 2012; 3: 216–24.
• 10
  Zeuzem S, Asselah T, Angus P, et al. , Efficacy of the protease inhibitor BI 201335, polymerase inhibitor BI 207127, and ribavirin in patients with chronic HCV infection. Gastroenterology 2011; 6: 2047–55.