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[Chronic hepatitis C].
Dtsch Med Wochenschr 2010; 135(50):2525-34; quiz 2535-8DM

Abstract

Chronic hepatitis C virus (HCV) infection is an important, global pathognomonic causal factor for development of liver cirrhosis and hepatocellular carcinoma. After parenteral transmission of the virus the majority of cases develop a chronic infection. Nowadays, the diagnosis of HCV-infection is made frequently in an advanced disease-stage due to an increasing number of patients with long durations of chronic infection and typically asymptomatic disease progression. The detection of HCV antibodies is suitable for the initial screening in the diagnosis of chronic Hepatitis C-infection. In patients with positive HCV antibodies, testing for HCV RNA by a sensitive assay is required to differentiate between an ongoing and a past infection. Prior to initiation of antiviral therapy, HCV genotype and HCV viral load should be determined together with a comprehensive diagnostic framework (including determination of the extent of liver fibrosis, exclusion of hepatocellular carcinoma and a concomitant liver disease). All treatment-naive patients with chronic hepatitis C should be considered for antiviral treatment since the eradication of the virus is associated with reduction of HCV related mortality and increasing age as well as increasing fibrosis is associated with reduced virologic response rates. In pretreated patients, decision on retreatment should be based on the potential for optimization of conditions for a second treatment in each individual case. Based mainly on the viral load before treatment initiation and virologic response during antiviral therapy rules for early treatment discontinuations in non-responders as well as for individualized durations of treatment for virologic responders have been established. Currently, approximately 50 % of treatment-naïve patients with genotype 1 infection and 80 % of patients with genotype 2/3 infection achieve a sustained virologic response with eradication of the virus. With the approval of triple therapies of HCV protease inhibitors (telaprevir and boceprevir) together with the current standard of care in 2011/2012 sustained virologic response rates of HCV genotype 1 patients will be improved by approximately 30 %.

Authors+Show Affiliations

Medizinische Klinik 1, Klinikum der J. W. Goethe-Universität, Frankfurt am Main.No affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article
Review

Language

ger

PubMed ID

21140330

Citation

Grammatikos, G, and C Sarrazin. "[Chronic Hepatitis C]." Deutsche Medizinische Wochenschrift (1946), vol. 135, no. 50, 2010, pp. 2525-34; quiz 2535-8.
Grammatikos G, Sarrazin C. [Chronic hepatitis C]. Dtsch Med Wochenschr. 2010;135(50):2525-34; quiz 2535-8.
Grammatikos, G., & Sarrazin, C. (2010). [Chronic hepatitis C]. Deutsche Medizinische Wochenschrift (1946), 135(50), pp. 2525-34; quiz 2535-8. doi:10.1055/s-0030-1269423.
Grammatikos G, Sarrazin C. [Chronic Hepatitis C]. Dtsch Med Wochenschr. 2010;135(50):2525-34; quiz 2535-8. PubMed PMID: 21140330.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Chronic hepatitis C]. AU - Grammatikos,G, AU - Sarrazin,C, Y1 - 2010/12/07/ PY - 2010/12/9/entrez PY - 2010/12/9/pubmed PY - 2010/12/31/medline SP - 2525-34; quiz 2535-8 JF - Deutsche medizinische Wochenschrift (1946) JO - Dtsch. Med. Wochenschr. VL - 135 IS - 50 N2 - Chronic hepatitis C virus (HCV) infection is an important, global pathognomonic causal factor for development of liver cirrhosis and hepatocellular carcinoma. After parenteral transmission of the virus the majority of cases develop a chronic infection. Nowadays, the diagnosis of HCV-infection is made frequently in an advanced disease-stage due to an increasing number of patients with long durations of chronic infection and typically asymptomatic disease progression. The detection of HCV antibodies is suitable for the initial screening in the diagnosis of chronic Hepatitis C-infection. In patients with positive HCV antibodies, testing for HCV RNA by a sensitive assay is required to differentiate between an ongoing and a past infection. Prior to initiation of antiviral therapy, HCV genotype and HCV viral load should be determined together with a comprehensive diagnostic framework (including determination of the extent of liver fibrosis, exclusion of hepatocellular carcinoma and a concomitant liver disease). All treatment-naive patients with chronic hepatitis C should be considered for antiviral treatment since the eradication of the virus is associated with reduction of HCV related mortality and increasing age as well as increasing fibrosis is associated with reduced virologic response rates. In pretreated patients, decision on retreatment should be based on the potential for optimization of conditions for a second treatment in each individual case. Based mainly on the viral load before treatment initiation and virologic response during antiviral therapy rules for early treatment discontinuations in non-responders as well as for individualized durations of treatment for virologic responders have been established. Currently, approximately 50 % of treatment-naïve patients with genotype 1 infection and 80 % of patients with genotype 2/3 infection achieve a sustained virologic response with eradication of the virus. With the approval of triple therapies of HCV protease inhibitors (telaprevir and boceprevir) together with the current standard of care in 2011/2012 sustained virologic response rates of HCV genotype 1 patients will be improved by approximately 30 %. SN - 1439-4413 UR - https://www.unboundmedicine.com/medline/citation/21140330/[Chronic_hepatitis_C]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0030-1269423 DB - PRIME DP - Unbound Medicine ER -