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Treatment of hepatitis C in special populations

Goki Suda1, Koji Ogawa2, Kenichi Morikawa2

  • 1Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. gsudgast@pop.med.hokudai.ac.jp.

Journal of Gastroenterology
|January 5, 2018
PubMed

Insights

Direct-acting antivirals (DAAs) offer a highly effective treatment for Hepatitis C virus (HCV) infection in special populations. These interferon-free therapies achieve high sustained viral response rates with fewer adverse events.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Hepatitis C virus (HCV) infection is a leading cause of liver cirrhosis and cancer.
  • HCV poses significant challenges in special populations like hemodialysis and liver transplant patients, often leading to poor outcomes.
  • Co-infection with human immunodeficiency virus (HIV) accelerates liver fibrosis in HCV patients.

Purpose of the Study:

  • To highlight the urgent need for effective Hepatitis C virus (HCV) treatment in vulnerable patient groups.
  • To evaluate the efficacy and safety of novel direct-acting antivirals (DAAs) compared to interferon-based therapies for HCV.
  • To assess the impact of DAAs on sustained viral response and adverse events in special populations.

Main Methods:

  • Review of current literature on Hepatitis C virus (HCV) treatment strategies.
  • Analysis of outcomes in hemodialysis, liver transplantation, and HIV co-infected patients treated with interferon-based therapies.
  • Evaluation of clinical trial data for interferon-free direct-acting antiviral (DAA) regimens in special populations.

Main Results:

  • Interferon-based therapies demonstrated limited efficacy and higher adverse events in special populations.
  • Interferon-free direct-acting antiviral (DAA) regimens achieved sustained viral response rates exceeding 90% in these groups.
  • DAA treatment was associated with a significantly lower incidence and severity of adverse events compared to older therapies.

Conclusions:

  • Direct-acting antivirals (DAAs) represent a transformative advancement in treating Hepatitis C virus (HCV) infection.
  • Interferon-free DAA therapy is highly effective and well-tolerated in hemodialysis, liver transplantation, and HIV co-infected patients.
  • DAAs provide a crucial therapeutic option for improving outcomes in special populations affected by HCV.

Keywords:
Direct-acting antiviralHCVHIVHemodialysisLiver transplantation

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