title: Hepatitis C virus treatment in the real world: optimising treatment and access to therapies.
abstract: Chronic HCV infections represent a major worldwide public health problem and are responsible for a large proportion of liver related deaths, mostly because of HCV-associated hepatocellular carcinoma and cirrhosis. The treatment of HCV has undergone a rapid and spectacular revolution. In the past 5 years, the launch of direct acting antiviral drugs has seen sustained virological response rates reach 90% and above for many patient groups. The new treatments are effective, well tolerated, allow for shorter treatment regimens and offer new opportunities for previously excluded groups. This therapeutic revolution has changed the rules for treatment of HCV, moving the field towards an interferon-free era and raising the prospect of HCV eradication. This manuscript addresses the new challenges regarding treatment optimisation in the real world, improvement of antiviral efficacy in 'hard-to-treat' groups, the management of patients whose direct acting antiviral drug treatment was unsuccessful, and access to diagnosis and treatment in different parts of the world.
authors.affiliation: Université Lyon 1, Cancer Research Center of Lyon (CRCL), INSERM U1052, Hospices Civils de Lyon, Lyon, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Zoulim
authors.affiliation: Liver Diseases Branch, NIDDK, NIH, Bethesda, Maryland, USA.
authors.forename: T Jake
authors.initials: TJ
authors.lastname: Liang
authors.affiliation: Klinikum der LMU München-Grosshadern, Liver Center Munich, University Hospital Munich, Munich, Germany.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Gerbes
authors.affiliation: U O Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Aghemo
authors.affiliation: Inserm, IAME, UMR 1137, Paris, France Univ Paris Diderot, Sorbonne Paris Cité, Paris, France Inserm, LIRIC-UMR995, Lille, France Univ Lille, Lille, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Deuffic-Burban
authors.affiliation: UCL Institute of Liver and Digestive Health, Royal Free Hospital London, London, UK.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Dusheiko
authors.affiliation: UNC Liver Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Fried
authors.affiliation: Université Paris Descartes, INSERM USM20, Institut Pasteur et Assistance Publique- Hôpitaux de Paris, Département d'Hépatologie, Hôpital Cochin, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.affiliation: Department of Medicine I, Jürgen Kurt Rockstroh: University Hospital Bonn, Bonn, Germany.
authors.forename: Jürgen Kurt
authors.initials: JK
authors.lastname: Rockstroh
authors.affiliation: University of California San Francisco, San Francisco, California, USA.
authors.forename: Norah A
authors.initials: NA
authors.lastname: Terrault
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wiktor
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D006297:Health Services Accessibility; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: HEPATITIS C