Hepatitis C Update

Abstract

The pace of Hepatitis C Virus (HCV) drug development in recent years has accelerated dramatically. But, for patients to benefit from these impressive advances, practitioners (i.e. 
“us”) need to know the most recent and accurate data on the diagnosis and treatment. In 2013, 
The American Association for Study of Liver Disease (AASLD) and the Infectious Disease 
Society of America (IDSA), put together web-based guidelines, which are frequently updated: 
www.hcvguidelines.org and www.aasld.org/practice-guidelines.
1
 The size of the problem: In 
the USA, the prevalence is 1.8% (4.1 million), 80% of them are viremic. It is the principal 
cause of death from liver disease. It is the leading indication for liver transplantation in the 
USA. Although, HCV is a curable disease, it is under-diagnosed and under-treated.2
 Three 
quarters of individuals with HCV are unaware they are infected. 66-87% of patients diagnosed 
with HCV have not received antiviral treatment. Screening and diagnosis: 65-69% of anti-HCV 
positive patients were born between 1945 and 1964. Persons born between 1945 and 1964 had 
a 4.6 times higher prevalence of HCV than persons born prior to 1945 or after 1964 (3.7% vs.
0.73%).3 Treatment: Before treatment, you need to know: genotype and viral load, previous 
treatment, and presence of absence of cirrhosis.4
 Generally speaking, 4 regimens are currently 
available. Ledipasvir/sofosbuvir × 12 weeks (8 weeks at discretion of practitioner), Paritaprevir/ritonavir/ombitasvir+dasabuvir + RBV × 12 weeks, Daclatasvir/sofosbuvir × 12 weeks and 
Sofusbuvir +Simeprevir±RBV × 12 weeks.