Hepatitis C: Is eradication possible?

Lombardi, Andrea; Mondelli, Mario U.

doi:10.1111/liv.14011

Cited by 90 publications

(61 citation statements)

References 74 publications

(94 reference statements)

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“…These are related to awareness of the infection, the economic feasibility of testing, treatment and linkage to care, the availability of the therapeutic drug regimens and reinfection rates. Unless a prophylactic vaccine becomes available, HCV elimination by 2030, as proposed by WHO, appears difficult to accomplish in certain regions/countries …”

Section: Discussionmentioning

confidence: 99%

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Hepatitis C elimination – Macro‐elimination

Kåberg

Weiland

2020

Liver International

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In 2016 the WHO set a goal to obtain an 80% reduction in new chronic HCV cases, requiring a level of diagnosis of 90%, treatment coverage of 80% and resulting in a 65% reduction in HCV‐related deaths by 2030. This goal is easier to reach in specific populations such as people who inject drugs (PWID), men who have sex with men (MSM) or blood‐transfusion recipients before screening for HCV became mandatory and in high‐income regions. It is much more difficult to achieve macro‐elimination throughout the population especially in low‐income areas with underdeveloped infrastructures, a high prevalence of HCV and limited economic resources. To achieve the WHO goals by 2030, awareness of HCV must increase and the cascade of care must be improved and implemented. Diagnostic procedures and treatment should be affordable and universally available. At the end of 2017 fewer than 15 countries were on track to reach these goals by 2030.

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Section: Discussionmentioning

confidence: 99%

“…Unless a prophylactic vaccine becomes available, HCV elimination by 2030, as proposed by WHO, appears difficult to accomplish in certain regions/countries. 41…”

Section: Summary and Con Clus I Onmentioning

confidence: 99%

Hepatitis C elimination – Macro‐elimination

Kåberg

Weiland

2020

Liver International

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“…Según la OMS, este objetivo es alcanzable si se logran reducir las nuevas infecciones en un 90% y la mortalidad asociada a eventos hepáticos en un 65%. Algunos autores han elaborado análisis que evalúan la factibilidad de este objetivo [40]. Un estudio epidemiológico realizado en España comparó la prevalencia de los anticuerpos anti-core y enfermedad activa por VHC en los años 2002, 2009, 2015 y 2016.…”

Section: Impacto Poblacional De La Curación Del Vhcunclassified

Actualización en el tratamiento de la coinfección por VIH y VHC en pacientes adultos

Crestelo¹,

Torralba

Zapata

2019

RIECS

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Resumen: El presente artículo es una revisión sobre el tratamiento del VHC en pacientes infectados por el VIH. Se aborda brevemente el contexto epidemiológico, la interacción existente entre ambos virus, y la historia natural e inmunopatogenia del VHC. Posteriormente se analizan las estrategias históricas (que incluían el interferón pegilado) y las actuales con los nuevos agentes antivirales directos. Se profundiza en las indicaciones, el concepto de respuesta viral sostenida, la eficacia, la toxicidad, y el tratamiento en situaciones especiales como la infección aguda por VHC o el trasplante hepático. Por último, se aborda la evolución de la fibrosis hepática, el trasplante hepático, el riesgo de hepatocarcinoma y el impacto poblacional de la curación de la infección por VHC.

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“…Approval of IFN-free DAAs targeting the NS3/4A protease, NS5A, and NS5B polymerase have now rapidly changed the therapeutic landscape for curing HCV infection at a very high rate. 25,26 In the future, HCV cure by DAAs is expected to reduce the incidence of chronic liver disease, liver cirrhosis, HCC, which result in decreased liver-related mortality. 27,28 Recently, emerging clinical studies with DAAs in patients with liver cirrhosis created a heated debate about the risk of HCC occurrence and recurrence after viral cure.…”

Section: Introductionmentioning

confidence: 99%

<p>Hepatocellular Carcinoma Mechanisms Associated with Chronic HCV Infection and the Impact of Direct-Acting Antiviral Treatment</p>

Dash¹,

Aydın²,

Widmer³

et al. 2020

JHC

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Hepatitis C virus (HCV) infection is the major risk factor for liver cirrhosis and hepatocellular carcinoma (HCC). The mechanisms of HCC initiation, growth, and metastasis appear to be highly complex due to the decade-long interactions between the virus, immune system, and overlapping bystander effects of host metabolic liver disease. The lack of a readily accessible animal model system for HCV is a significant obstacle to understand the mechanisms of viral carcinogenesis. Traditionally, the primary prevention strategy of HCC has been to eliminate infection by antiviral therapy. The success of virus elimination by antiviral treatment is determined by the SVR when the HCV is no longer detectable in serum. Interferon-alpha (IFNα) and its analogs, pegylated IFN-α (PEG-IFN-α) alone with ribavirin (RBV), have been the primary antiviral treatment of HCV for many years with a low cure rate. The cloning and sequencing of HCV have allowed the development of cell culture models, which accelerated antiviral drug discovery. It resulted in the selection of highly effective direct-acting antiviral (DAA)-based combination therapy that now offers incredible success in curing HCV infection in more than 95% of all patients, including those with cirrhosis. However, several emerging recent publications claim that patients who have liver cirrhosis at the time of DAAs treatment face the risk of HCC occurrence and recurrence after viral cure. This remains a substantial challenge while addressing the long-term benefit of antiviral medicine. The host-related mechanisms that drive the risk of HCC in the absence of the virus are unknown. This review describes the multifaceted mechanisms that create a tumorigenic environment during chronic HCV infection. In addition to the potential oncogenic programming that drives HCC after viral clearance by DAAs, the current status of a biomarker development for early prediction of cirrhosis regression and HCC detection post viral treatment is discussed. Since DAAs treatment does not provide full protection against reinfection or viral transmission to other individuals, the recent studies for a vaccine development are also reviewed.

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Hepatitis C: Is eradication possible?

Cited by 90 publications

References 74 publications

Hepatitis C elimination – Macro‐elimination

Hepatitis C elimination – Macro‐elimination

Actualización en el tratamiento de la coinfección por VIH y VHC en pacientes adultos

<p>Hepatocellular Carcinoma Mechanisms Associated with Chronic HCV Infection and the Impact of Direct-Acting Antiviral Treatment</p>

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