August 2017 Volume 21, Issue 3
Hepatitis C Genotype 3 Infection Pathogenesis and Treatment Horizons
Haripriya Maddur, MD*, Steven L. Flamm, MD
Abstract
Genotype 3 hepatitis C infection is the second most common genotype worldwide and accounts for most infections in Southeast Asia. It is a particularly ominous genotype because it has been linked to increased mortality, specifically increased late-stage liver events, accelerated development of hepatic fibrosis, and an increased risk of hepatocellular carcinoma. As new treatment regimens for hepatitis C have been emerging, treatment of genotype 3 often requires longer treatment duration with decreased response rates as compared with other genotypes.
KEY POINTS Hepatitis C genotype 3 infection is associated with increased late-stage liver events, accelerated hepatic fibrosis, and hepatocellular carcinoma.
Infection with genotype 3 infection has been linked to hepatic steatosis thought to be related to direct viral protein effect on hepatocytes.
With the advent of direct-acting antiviral therapies, infection with genotype 3 has been found to be more difficult to treat as compared with other genotypes.
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Of Interest
Shortening the duration of therapy for chronic HCV
Lancet Published online August 9, 2017
Combination direct-acting antiviral therapy of 8–24 weeks is highly effective for the treatment of chronic hepatitis C infection. However, shortening the treatment duration to less than 8 weeks could potentially reduce overall treatment costs and improve adherence. Here we explore the arguments for and against the development of short-duration regimens and existing data on treatment for 6 weeks or less among patients with chronic hepatitis C virus genotype 1 infection. Additionally, we identify potential predictors of response to short-course combination therapies with direct-acting antiviral drugs that might be explored in future clinical trials.
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