a Hepatology Unit, Ospedale San Giuseppe , University of Milan , Milan , Italy.
b Department Medicine of Systems , University Tor Vergata , Rome , Italy.
Expert Rev Anti Infect Ther. 2019 Feb;17(2):117-128. doi: 10.1080/14787210.2019.1563755. Epub 2019 Jan 15.
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Treatment of chronic hepatitis C has considerably improved in the last few years thanks to the introduction of direct-acting antivirals able to achieve sustained virological response in more than 95% of patients. Successful anti-HCV treatment can halt liver disease progression and solve the HCV-related extra-hepatic manifestations, eventually reducing liver-related and overall mortality. Areas covered: With the aim to respond to unmet needs in patient's identification, universal access to antiviral therapy and treatment optimization in specific setting of HCV-infected patients, a group of Italian experts met in Stresa in May 2018. The summary of the considerations arising from this meeting and the final statements are reported in this paper. Expert commentary: All the advances on HCV cure may have a real clinical impact not only in individual patients but also at the social health level if they are applied to all infected patients, independently from the stage of liver disease. Further improvements are needed in order to attain HCV elimination, such as the development of an enhanced screening program working in parallel to the present treatment options.
丙型肝炎病毒 (HCV) 感染是慢性肝病的主要病因,全世界约有 7100 万人慢性感染 HCV。由于直接作用抗病毒药物的问世,能够使超过 95%的患者达到持续病毒学应答,慢性丙型肝炎的治疗在过去几年中得到了显著改善。成功的抗 HCV 治疗可以阻止肝病进展并解决 HCV 相关的肝外表现,最终降低与肝脏相关的死亡率和总体死亡率。
为了应对患者识别、抗病毒治疗的普遍可及性以及 HCV 感染患者特定情况下的治疗优化方面的未满足需求,一组意大利专家于 2018 年 5 月在斯塔雷萨举行了会议。本文报告了此次会议产生的思考总结和最终声明。
如果将所有这些 HCV 治愈方面的进展应用于所有感染患者,而不仅仅是个体患者,那么它们可能会对个人临床产生真正的影响,也会对社会健康水平产生影响,无论其肝病阶段如何。为了实现 HCV 的消除,还需要进一步的改进,例如开发增强的筛查计划,与现有的治疗方案并行。