Loustaud-Ratti Véronique, Debette-Gratien Marilyne, Carrier Paul
Fédération d'Hépatologie, Service d'Hépato-gastroentérologie, CHU Limoges, Limoges 87042, France.
World J Hepatol. 2018 Oct 27;10(10):639-644. doi: 10.4254/wjh.v10.i10.639.
The latest Association Française pour l'Etude du Foie - French Association for Study of the Liver (AFEF) and European Association for the Study of the Liver (EASL) recommendations announce a change of paradigm, for the management of patients infected with hepatitis C virus (HCV). The AFEF recommendations focus on the elimination of HCV infection on a national level by preventing reinfection, in less than ten years. This goal involves the facilitation of patients' management in a simplified pathway by increasing screening procedures and access to pangenotypic treatments mainly in the "reservoir" population of people who inject drugs and migrants. Even in the complex pathway of patients with previous comorbidities, AFEF takes the option of a therapeutic simplification. The EASL guidelines position themselves on the state of the art with a precise description of all therapeutic options available, without separating simplified and complex pathways even if they take into account the epidemiological evolution of difficult-to-treat populations.
法国肝脏研究协会(AFEF)和欧洲肝脏研究协会(EASL)的最新建议宣布了丙型肝炎病毒(HCV)感染患者管理模式的转变。AFEF的建议侧重于在不到十年的时间内,通过预防再次感染在国家层面消除HCV感染。这一目标包括通过增加筛查程序以及主要在注射吸毒者和移民这一“蓄水池”人群中提供泛基因型治疗,来简化患者管理途径。即使在有既往合并症患者的复杂管理途径中,AFEF也选择了治疗简化方案。EASL指南基于当前的技术水平,精确描述了所有可用的治疗选择,即使考虑到难治人群的流行病学演变,也没有区分简化和复杂途径。