title: Hepatitis C virus markers in infection by hepatitis C virus: In the era of directly acting antivirals.
abstract: About 130-170 million people are infected with the hepatitis C virus (HCV) worldwide and more than 350000 people die each year of HCV-related liver diseases. The combination of pegylated interferon (Peg-IFN) and ribavirin (RBV) was recommended as the treatment of choice for chronic hepatitis C for nearly a decade. In 2011 the directly acting antivirals (DAA) HCV NS3/4A protease inhibitors, telaprevir and boceprevir, were approved to treat HCV-genotype-1 infection, each in triple combination with Peg-IFN and RBV. These treatments allowed higher rates of SVR than the double Peg-IFN + RBV, but the low tolerability and high pill burden of these triple regimes were responsible for reduced adherence and early treatment discontinuation. The second and third wave DAAs introduced in 2013-2014 enhanced the efficacy and tolerability of anti-HCV treatment. Consequently, the traditional indicators for disease management and predictors of treatment response should be revised in light of these new therapeutic options. This review article will focus on the use of the markers of HCV infection and replication, of laboratory and instrumental data to define the stage of the disease and of predictors, if any, of response to therapy in the DAA era. The article is addressed particularly to physicians who have patients with hepatitis C in care in their everyday clinical practice.
authors.affiliation: Nicola Coppola, Mariantonietta Pisaturo, Margherita Macera, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
authors.affiliation: Nicola Coppola, Mariantonietta Pisaturo, Margherita Macera, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Pisaturo
authors.affiliation: Nicola Coppola, Mariantonietta Pisaturo, Margherita Macera, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Zampino
authors.affiliation: Nicola Coppola, Mariantonietta Pisaturo, Margherita Macera, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Margherita
authors.initials: M
authors.lastname: Macera
authors.affiliation: Nicola Coppola, Mariantonietta Pisaturo, Margherita Macera, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Sagnelli
authors.affiliation: Nicola Coppola, Mariantonietta Pisaturo, Margherita Macera, Evangelista Sagnelli, Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, 80131 Naples, Italy.
authors.forename: Evangelista
authors.initials: E
authors.lastname: Sagnelli
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D012367:RNA, Viral / Q000097:blood*; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D012367:RNA, Viral
keywords: Chronic hepatitis C; Directly acting antivirals; Hepatitis C virus infection; Hepatitis C virus replication; Staging