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Published on: February 1, 2017
Treatment of early stage chronic hepatitis C virus infection
Francesca Romana Ponziani1, Luca Miele1, Annalisa Tortora1
1a Internal Medicine, Gastroenterology and Hepatology Unit, Fondazione Policlinico "A. Gemelli" , Catholic University of Rome , Rome , Italy.
Insights
Treating early-stage Hepatitis C Virus (HCV) infection with direct-acting antivirals (DAAs) offers significant benefits beyond liver health. Early intervention improves extra-hepatic conditions and quality of life, making it a rewarding approach.
Area of Science:
- Hepatology
- Virology
- Pharmacoeconomics
Background:
- Hepatitis C Virus (HCV) infection is effectively treated with direct-acting antivirals (DAAs), achieving high cure rates.
- The primary barrier to widespread HCV treatment is the high cost of DAAs.
- Early-stage treatment of HCV infection is increasingly recognized as a highly beneficial strategy.
Purpose of the Study:
- To review the advantages of treating chronic HCV infection during its early stages.
- To assess considerations for initiating HCV treatment in patients with minimal liver disease.
- To evaluate the impact of viral eradication on extra-hepatic manifestations and quality of life.
Main Methods:
- Literature review focusing on early-stage HCV treatment benefits.
- Analysis of HCV-associated conditions affected by viral eradication.
- Evaluation of pharmaco-economic data related to early HCV treatment.
Main Results:
- HCV viral eradication in early disease positively impacts lymphoma risk, insulin resistance, glycemic control, and renal function.
- Early treatment leads to improvements in patients' overall quality of life.
- Pharmaco-economic analysis supports the cost-effectiveness of early HCV intervention.
Conclusions:
- Treating HCV in patients with minimal liver disease yields pleiotropic benefits extending beyond liver outcomes.
- Early HCV treatment is a clinically and economically advantageous strategy.
- Viral eradication offers a comprehensive approach to managing HCV and its associated comorbidities.
Introduction:
Treatment of Hepatitis C Virus (HCV) with direct acting antivirals (DAAs) is able to achieve the cure of infection in almost the totality of patients, independently of the characteristics of the individual and the virus, using short treatment schedules, and without the need of ribavirin. The high cost of DAAs is the main limiting factor for universal treatment of HCV. However, there is a strong evidence that treatment of infection at the early stage of disease may be the most rewarding approach. Areas covered: This review evaluates the aspects underlying the benefit of treating chronic HCV infection at the early stage of disease. It outlines the considerations that have to be taken into account when planning treatment in patients with HCV and minimal liver disease, assessing the positive reflex of viral eradication on several HCV-associated extra-hepatic conditions such as the risk of lymphoma, insulin-resistance and glycaemic control, and renal function. Lastly, it also covers the improvement of patients' quality of life and the pharmaco-economic aspects associated with early treatment. Expert commentary: Treatment of patients with HCV and minimal liver disease is associated with a beneficial, pleiotropic effect of viral eradication that goes beyond the simplistic consideration of the improvement in liver disease-related outcomes.
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