Expanded benefits of curing the extrahepatic manifestations of HCV infection

Negro, Francesco

doi:10.1136/gutjnl-2018-316578

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…6,[9][10][11][12][13][14][15][16][17] HCV is also associated with a number of extrahepatic manifestations, but viral elimination can reduce allcause mortality. [18][19][20][21][22][23][24][25] This final update of the EASL Recommendations on Treatment of Hepatitis C series started in 2014 is intended to assist physicians and other healthcare providers, as well as patients and other interested individuals, in the clinical decisionmaking process, by describing the current optimal management of patients with acute and chronic HCV infections. These recommendations apply to therapies that have been approved by the European Medicines Agency and other national European agencies at the time of their publication.…”

Section: Introduction Backgroundmentioning

confidence: 99%

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Pawlotsky¹,

Negro²,

Aghemo³

et al. 2020

Journal of Hepatology

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632

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Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Clinical care for patients with HCV-related liver disease has advanced considerably thanks to an enhanced understanding of the pathophysiology of the disease, as well as developments in diagnostic procedures and improvements in therapy and prevention. These therapies make it possible to eliminate hepatitis C as a major public health threat, as per the World Health Organization target, although the timeline and feasibility vary from region to region. These European Association for the Study of the Liver recommendations on treatment of hepatitis C describe the optimal management of patients with recently acquired and chronic HCV infections in 2020 and onwards.

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Section: Introduction Backgroundmentioning

confidence: 99%

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Pawlotsky¹,

Negro²,

Aghemo³

et al. 2020

Journal of Hepatology

Self Cite

805

632

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“…The wide mosaic of such manifestations has been described as ‘HCV syndrome’ and represents the clinical expression of the biological effects of HCV . The two major metabolic manifestations of the syndrome are insulin resistance and type II diabetes mellitus . Previous data hypothesized a pilot role of HCV in favouring the development of IR, and IR was attributed to HCV active infection per se rather than to advanced liver fibrosis .…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C virus eradication with direct‐acting antiviral improves insulin resistance

Russo

Zanetto

Gambato

et al. 2019

Journal of Viral Hepatitis

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Sustained virological response (SVR) after interferon-based therapy is associated with improvement of insulin resistance (IR) in HCV-infected patients. Few data are available in the direct-acting antivirals (DAAs) era, especially in cirrhotic patients. We prospectively evaluated the long-term effect of DAAs on IR. Patients treated with DAAs between May 2015 and December 2016 in 3 tertiary care centres were recruited. Patients with diabetes were excluded. Biochemical and virological data were collected at baseline, 12/24/48 weeks (W) after the end of therapy (EOT). Presence of IR was defined by a 'homeostasis model assessment index for IR' [HOMA-IR])> 2.5. Liver fibroscan was performed at baseline, at 24/48W after EOT. Hundred and thirty-eight patients were enrolled (mean age 58 years, M/F 85/53, GT1 61%, 68.8% cirrhotic). Sixty-eight patients (94/138) had IR. Patients with IR had significantly higher stiffness than patients without it (23 ± 12 vs 15 ± 8; P < .0001). SVR12 was achieved in 135 (98%) patients, and 124 (90%) patients reached the 48W post-EOT.At this time point, the percentage of patients with IR significantly decreased to 49% (P = 0,01). HOMA-IR was significantly lower than baseline (1.8 vs 3; P < .001), and this was related to a significant reduction of insulin level (11.7 ± 6.3 vs 16.4 ± 8.3). High BMI was associated with a significantly lower probability of achieving a non-IR status at 24W (P = .05) and 48W (P = .03).In conclusion, SVR following DAAs led to a significant reduction of IR, even in patients with cirrhosis. Nevertheless, IR can persist after the achievement of SVR, especially in patients with high BMI. K E Y W O R D S cirrhosis, Diabetes, direct-acting antivirals, hepatitis C virus | 189 RUSSO et al.

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“…• Пациентам с внепеченочными иммунологически обусловленными проявлениями ХВГС рекомендуется назначить ПППД по описанным выше схемам [23,[148][149][150].…”

Section: внепеченочные проявления хронического вирусного гепатита сunclassified

Clinical Practice Guidelines of the Russian Society for the Study of the Liver, the Russian Gastroenterological Association, the National Scientific Society of Infectious Disease Specialists for the Diagnosis and Treatment of Chronic Hepatitis C

Chulanov

Мамонова

et al. 2023

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Аim: diagnosis and treatment algorithms in the clinical recommendations intended for general practitioners, gastroenterologists, infectious disease specialists, hepatologists on the of chronic hepatitis C are presented.Summary. Chronic viral hepatitis C is a socially significant infection, the incidence of which in the Russian Federation remains significantly high. Over the past 10 years, great progress has been made in the treatment of hepatitis C — direct acting antiviral drugs have appeared. The spectrum of their effectiveness allows to achieve a sustained virological response in more than 90 % of cases, even in groups that were not previously considered even as candidates for therapy or were difficult to treat — patients receiving renal replacement therapy, after liver transplantation (or other organs), at the stage of decompensated liver cirrhosis, HIV co-infected, etc. Interferons are excluded from the recommendations due to their low effectiveness and a wide range of adverse events. The indications for the treatment have been expanded, namely, the fact of confirmation of viral replication. The terms of dispensary observation of patients without cirrhosis of the liver have been reduced (up to 12 weeks after the end of therapy). Also, these recommendations present approaches to active screening of hepatitis in risk groups, preventive and rehabilitation measures after the end of treatment.Conclusion. Great success has been achieved in the treatment of chronic hepatitis C. In most cases, eradication of viral HCV infection is a real task even in patients at the stage of cirrhosis of the liver, with impaired renal function, HIV co-infection, after solid organs transplantation.

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Expanded benefits of curing the extrahepatic manifestations of HCV infection

Cited by 6 publications

References 9 publications

EASL recommendations on treatment of hepatitis C: Final update of the series☆

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Hepatitis C virus eradication with direct‐acting antiviral improves insulin resistance

Clinical Practice Guidelines of the Russian Society for the Study of the Liver, the Russian Gastroenterological Association, the National Scientific Society of Infectious Disease Specialists for the Diagnosis and Treatment of Chronic Hepatitis C

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