Management of hepatitis C.
Hepatitis C virus (HCV) infection is a common cause of chronic liver disease and hepatocellular carcinoma. It is estimated that 15-20% of those infected will develop cirrhosis after 20 years of infection. It is transmitted parenterally, and HCV antibody and HCV RNA tests diagnose infection with a high degree of accuracy. Currently, a combination of peginterferon and ribavirin is the most efficacious treatment, with sustained viral response rates of 45% for genotype 1 and 80% for genotypes 2 and 3. There is some evidence that treatment with interferon-based regimens can improve the natural history of this infection. The side effects of treatment are well recognized and include leucopenia, thrombocytopenia, haemolytic anaemia and depression. Patients with HCV-related decompensated cirrhosis and/or hepatocellular carcinoma should be considered for liver transplantation. The management of special groups, including those with acute HCV infection, co-infected with hepatitis B (HBV) or human immunodeficiency virus (HIV), continues to be defined.
Gastrointestinal and Liver Diseases Department, The Royal Infirmary of Edinburgh, Edinburgh,UK. mjteo@bigpond.com
Marcus
M
Teo
Peter
P
Hayes
D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000517:prevention & control; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy / Q000235:genetics / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy; D016899:Interferon-beta; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000517:prevention & control; D008113:Liver Neoplasms / Q000517:prevention & control; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use
D000998:Antiviral Agents; D011092:Polyethylene Glycols; D012254:Ribavirin; D016899:Interferon-beta; D007372:Interferons; C428112:peginterferon beta-1a