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The impact of hepatitis C virus outside the liver: Evidence from Asia
Author(s) -
Younossi Zobair M.,
Tanaka Atsushi,
Eguchi Yuichiro,
Lim YoungSuk,
Yu MingLung,
Kawada Norifumi,
Dan Yock Young,
BrooksRooney Craig,
Negro Francesco,
Mondelli Mario U.
Publication year - 2017
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/liv.13272
Subject(s) - medicine , ribavirin , pegylated interferon , discontinuation , hepatocellular carcinoma , hepatitis c , adverse effect , liver disease , cirrhosis , regimen , hepatitis c virus , sofosbuvir , alpha interferon , gastroenterology , immunology , interferon , virus
Between 80 and 115 million people worldwide are chronically infected with hepatitis C virus, with 60%‐90% of these being undiagnosed. Untreated chronic hepatitis C ( CHC ) is associated with progressive liver disease, cirrhosis, hepatocellular carcinoma and liver‐related mortality. A number of extrahepatic manifestations are also reported in CHC patients, further adding to the burden of the disease. CHC also impacts patients in terms of lower health‐related quality of life, higher levels of fatigue and reduced productivity. Furthermore, the later stages of disease are costly for both healthcare systems and society. Pegylated‐interferon ( PEG ‐ IFN )+ribavirin ( RBV ), for many years the mainstay of treatment, leads to sustained virological response ( SVR ) in 40%‐70% of patients. However, a substantial number of patients are ineligible for treatment, and many patients fail to achieve SVR with this regimen. Furthermore, PEG ‐ IFN + RBV leads to impairment of patient‐reported outcomes during treatment, and most patients suffer from adverse events, associated with poor adherence, treatment discontinuation and treatment failure. The approval of second‐generation direct‐acting antivirals ( DAA s) has revolutionized the treatment of CHC patients. All‐oral, PEG ‐ IFN and RBV ‐free regimens have higher efficacy rates, shorter treatment durations, fewer adverse events, higher adherence rates and improvement in PRO s from as early as Week 4, compared to PEG ‐ IFN + RBV regimens. The aim of this article is to review the evidence for HCV infection as a systemic disease, summarizing the impact of hepatitis C and its treatments on clinical, patient and economic outcomes, with a focus on data from Asia and Japan specifically.