title: Why I do not treat patients for mild disease.
abstract: The short-term prognosis of patients with chronic hepatitis C and mild disease is excellent. Monitoring of the progression of fibrosis is easy to perform with non-invasive tests. Current all-oral interferon (IFN)- and ribavirin (RBV)-free regimens offer sustained viral response (SVR) rates of more than 90% as well as 12-weeks of treatment for most patients with mild disease. Several DAA combinations can be selected to optimize efficacy and safety outcomes. A short treatment duration of 8 weeks could be indicated in most patients with mild disease. However, additional data from clinical trials and real-life experience are needed to confirm this option. Moreover, current regimens are not cost-effective for patients with mild disease. In practice, deferral of HCV treatment for a few years and monitoring the progression of fibrosis is a safe option until cheaper, shorter, more effective and more convenient HCV regimens become available.
authors.affiliation: Department of Hepatology and Gastroenterology, Hôpital Henri Mondor, AP-HP, Université Paris-Est, INSERM U955, Créteil, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Hézode
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000175:diagnosis; D012254:Ribavirin / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin
keywords: IFN-free; cost; direct-acting antiviral; fibrosis progression; ribavirin