From current status to optimization of HCV treatment: Recommendations from an expert panel

Area of Science:

• Hepatology
• Virology
• Public Health

Background:

• Chronic hepatitis C virus (HCV) infection poses a significant global health burden, leading to severe liver and extra-hepatic complications.
• Direct-acting antiviral (DAA) agents have transformed HCV treatment, offering high efficacy and tolerability with sustained virological response (SVR) rates exceeding 90% in many patient groups.
• Interferon-free regimens are now the standard of care for all patients with chronic hepatitis C (CHC).

Purpose of the Study:

• To optimize HCV treatment strategies by addressing gaps in current guidelines.
• To provide expert recommendations for managing clinical challenges not fully covered by existing guidelines.
• To consolidate expert opinions on HCV treatment in light of evolving therapeutic landscapes.

Main Methods:

• A consensus meeting of Italian experts in HCV infection treatment was convened in February 2016.
• Discussions focused on treatment optimization, unmet needs, and practical clinical management issues.
• The meeting resulted in a position paper summarizing considerations and final statements.

Main Results:

• DAA-based regimens are highly effective, leading to SVR and preventing disease progression.
• Successful treatment can resolve extra-hepatic manifestations and reduce overall mortality.
• Current guidelines may not be universally applicable due to cost, prioritizing advanced liver disease, and lacking specific answers for complex cases.

Conclusions:

• Interferon-free DAA regimens represent the current standard of care for CHC.
• Addressing treatment cost and expanding access to priority groups are crucial for global health equity.
• Expert consensus and position papers are valuable for refining clinical practice and managing complex patient scenarios in HCV treatment.