[Hepatitis C: epidemiology, management and treatment].
Hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease in western countries. The aim of this review is to provide an update on the epidemiology, diagnosis, management and therapy of the infection. It is estimated that about 400,000 persons in France have ongoing HCV infection. The estimated incidence is around 4000 cases per year. All patients with suspected chronic HCV infection should be tested for HCV RNA, as seropositivity without detectable viremia is frequent. The HCV genotype should be determined systematically prior to specific treatment in order to determine the optimal duration of therapy and the likelihood of response. Liver biopsy should be performed when the results are likely to influence the decision to treat. Treatment decisions should be individualized, being based on the severity of liver disease, the potential for serious adverse effects, the likelihood of a treatment response, and any comorbidity. The peginterferon-ribavirin combination is the treatment of choice, affording sustained viral clearance in up to 85% of patients infected by genotypes 2 and 3, and up to 50% in patients with genotype 1 infection.
Poupon
Raoul
R
Service d'Hépatologie, Hôpital Saint-Antoine, 75771 Paris.
D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D004359:Drug Therapy, Combination; D005838:Genotype; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics; D006801:Humans; D008099:Liver / Q000473:pathology; D012367:RNA, Viral / Q000032:analysis
D000998:Antiviral Agents; D012367:RNA, Viral