Update on Recently Approved Treatments for Hepatitis C

Chao, Daniel; Botwin, Gregory J.; Morgan, Timothy R.

doi:10.1007/s11938-014-0013-z

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…SVR achieved on interferon-based regimens has been shown to be associated with resolution of liver disease and prevention of long-term complications in patients without cirrhosis; however, achievement of SVR after the development of cirrhosis greatly reduces but does not completely eliminate the risk of HCC [8,9]. With the recent introduction of oral, curative, but highly expensive antiviral drugs [10], a priority research question is comparative benefits and harms of treating patients with HCV infection at the time of diagnosis vs waiting to treat only those patients who show early signs of progression of liver disease or other manifestations of HCV infection [11]. Furthermore, since some payers introduced policies to limit access to treatment in reaction to the high cost of newer regimens, there has been an ongoing debate regarding whether delaying therapy is justifiable, and thus, data about the progression of untreated early-stage HCV infection from large and diverse cohorts are critical [12,13].…”

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confidence: 99%

All-Cause Mortality and Progression Risks to Hepatic Decompensation and Hepatocellular Carcinoma in Patients Infected With Hepatitis C Virus

Xu¹,

Moorman²,

Tong³

et al. 2015

Clin Infect Dis.

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Background. A key question in care of patients with chronic hepatitis C virus (HCV) infection is beginning treatment immediately vs delaying treatment. Risks of mortality and disease progression in "real world" settings are important to assess the implications of delaying HCV treatment.Methods. This was a cohort study of HCV patients identified from 4 integrated health systems in the United States who had liver biopsies during 2001-2012. The probabilities of death and progression to hepatocellular carcinoma, hepatic decompensation (hepatic encephalopathy, esophageal varices, ascites, or portal hypertension) or liver transplant were estimated over 1, 2, or 5 years by fibrosis stage (Metavir F0-F4) determined by biopsy at beginning of observation.Results. Among 2799 HCV-monoinfected patients who had a qualifying liver biopsy, the mean age at the time of biopsy was 50.7 years. The majority were male (58.9%) and non-Hispanic white (66.9%). Over a mean observation of 5.0 years, 261 (9.3%) patients died and 34 (1.2%) received liver transplants. At 5 years after biopsy, the estimated risk of progression to hepatic decompensation or hepatocellular carcinoma was 37.2% in stage F4, 19.6% in F3, 4.7% in F2, and 2.3% in F0-F1 patients. Baseline biopsy stage F3 or F4 and platelet count below normal were the strongest predictors of progression to hepatic decompensation or hepatocellular carcinoma.Conclusions. The risks of death and progression to liver failure varied greatly by fibrosis stage. Clinicians and policy makers could use these progression risk data in prioritization and in determining the timing of treatment for patients in early stages of liver disease.

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confidence: 99%

All-Cause Mortality and Progression Risks to Hepatic Decompensation and Hepatocellular Carcinoma in Patients Infected With Hepatitis C Virus

Xu¹,

Moorman²,

Tong³

et al. 2015

Clin Infect Dis.

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“…In December 2013, 2 orally administered DAAs, simeprevir (SIM) and sofosbuvir (SOF), were approved by the US Food and Drug Administration (FDA) for the treatment of HCV infection. 1 A third agent, ledipasvir and SOF (combined as a single pill), was approved by the FDA in October 2014 for HCV genotype 1.…”

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confidence: 99%

Serious Pulmonary Toxicity Secondary to Novel Hepatitis C Antiviral Therapy in a Liver Transplant Recipient

Helmers

Byrne

Wesselius

et al. 2015

Mayo Clinic Proceedings

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Historically, the treatment of hepatitis C virus infection has been difficult, but therapeutic options have improved markedly recently because of the development of novel antiviral therapies. These therapies have been well tolerated. We describe a patient who was receiving such therapy and had development of temporally related and histologically confirmed severe pulmonary toxicity. Pulmonary toxicity should be considered a potential serious complication of novel antiviral therapy for hepatitis C virus infection.

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“…Despite the development of drug resistance, the initial NS3-4A protease inhibitors (PI) telaprevir and boceprevir undoubtedly possessed advantages over dual IFN/RBV treatment [ 78 ]. The success of both drugs was subsequently eclipsed by the licensing of simeprevir and sofosbuvir [ 79 , 80 , 81 , 82 ]. The field of HCV therapy is rapidly evolving, and as a result, a large number of new antiviral drugs are currently being evaluated in advanced clinical trials [ 83 ].…”

Section: Historical Timeline Of Hcv Characterizationmentioning

confidence: 99%

Advanced Molecular Surveillance of Hepatitis C Virus

Rossi

Escobar‐Gutiérrez

Rahal

2015

Viruses

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Hepatitis C virus (HCV) infection is an important public health problem worldwide. HCV exploits complex molecular mechanisms, which result in a high degree of intrahost genetic heterogeneity. This high degree of variability represents a challenge for the accurate establishment of genetic relatedness between cases and complicates the identification of sources of infection. Tracking HCV infections is crucial for the elucidation of routes of transmission in a variety of settings. Therefore, implementation of HCV advanced molecular surveillance (AMS) is essential for disease control. Accounting for virulence is also important for HCV AMS and both viral and host factors contribute to the disease outcome. Therefore, HCV AMS requires the incorporation of host factors as an integral component of the algorithms used to monitor disease occurrence. Importantly, implementation of comprehensive global databases and data mining are also needed for the proper study of the mechanisms responsible for HCV transmission. Here, we review molecular aspects associated with HCV transmission, as well as the most recent technological advances used for virus and host characterization. Additionally, the cornerstone discoveries that have defined the pathway for viral characterization are presented and the importance of implementing advanced HCV molecular surveillance is highlighted.

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Update on Recently Approved Treatments for Hepatitis C

Cited by 7 publications

References 20 publications

All-Cause Mortality and Progression Risks to Hepatic Decompensation and Hepatocellular Carcinoma in Patients Infected With Hepatitis C Virus

All-Cause Mortality and Progression Risks to Hepatic Decompensation and Hepatocellular Carcinoma in Patients Infected With Hepatitis C Virus

Serious Pulmonary Toxicity Secondary to Novel Hepatitis C Antiviral Therapy in a Liver Transplant Recipient

Advanced Molecular Surveillance of Hepatitis C Virus

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