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2011 E uropean A ssociation of the S tudy of the L iver hepatitis C virus clinical practice guidelines
Author(s) -
Calvaruso Vincenza,
Craxì Antonio
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02703.x
Subject(s) - medicine , hepatocellular carcinoma , pegylated interferon , hepatitis c virus , ribavirin , hepatitis c , liver disease , immunology , virus , gastroenterology , virology
Hepatitis C virus ( HCV ) is the leading cause of liver transplantation in E urope and is associated with an increased risk of hepatocellular carcinoma ( HCC ). Because of the chronic nature of the disease, estimates suggest that the burden on healthcare will increase dramatically for this entity. Clinical care of patients with HCV ‐related liver disease has advanced considerably in the last two decades, thanks to increasing knowledge about the mechanisms of the disease, development of diagnostic procedures, and advances in therapeutic and preventive approaches. HCV RNA testing, HCV genotyping and staging of liver disease are essential for the diagnosis and the management of HCV therapy. Furthermore, the important role of host polymorphisms of the IL28B gene on virological response to treatment with pegylated interferon ( PEG ‐ IFN ) alpha and ribavirin ( RBV ) has recently been clearly demonstrated. In relation to treatment, although numerous drugs for HCV are in various stages of preclinical and clinical development, the current standard of care ( SoC ) is the combination of PEG ‐ IFN ‐α and RBV for chronic hepatitis C . With SoC , a sustained viral response ( SVR ) is achieved in approximately 45% of patients infected with HCV genotype 1 and in approximately 80% of patients infected with HCV genotypes 2 and 3. The EASL HCV guidelines recommend treating all naïve patients with compensated disease from HCV without contraindications to treatment and strongly suggest initiating SoC promptly in patients with advanced fibrosis. Further recommendations on monitoring treatment efficacy, treatment duration, dose reduction indications and the role of co‐factors are provided.