title: [Screening, diagnosis, treatment, and follow up of hepatitis C virus related liver disease. National consensus guideline in Hungary from 15 October 2016].
abstract: Treatment of hepatitis C is based on a national consensus guideline updated six-monthly according to local availability and affordability of approved therapies through a transparent allocation system in Hungary. This updated guideline incorporates some special new aspects, including recommendations for screening, diagnostics, use and allocation of novel direct acting antiviral agents. Indication of therapy in patients with no contraindication is based on demonstration of viral replication with consequent inflammation and/or fibrosis in the liver. Non-invasive methods (elastographies and biochemical methods) are preferred for liver fibrosis staging. The budget allocated for these patients is limited. Therefore, expensive novel direct acting antiviral combinations as first line treatment are reimbursed only, if the freely available, but less effective and more toxic pegylated interferon plus ribavirin dual therapy deemed to prone high chance of adverse events and/or low chance of cure. Priority is given to those with urgent need based on a pre-defined scoring system reflecting mainly the stage of the liver disease, but considering also additional factors, i.e., hepatic decompensation, other complications, activity and progression of liver disease, risk of transmission and other special issues. Approved treatments are restricted to the most cost-effective combinations based on the cost per sustained virological response value in different patient categories with consensus amongst treating physicians, the National Health Insurance Fund and patient's organizations. Interferon-free treatments and shorter therapy durations are preferred. Orv. Hetil., 2017, 158(Suppl. 1), 3-22.
authors.affiliation: Gasztroenterológia Osztály, Somogy Megyei Kaposi Mór Oktató Kórház Kaposvár, Tallián Gy. u. 20-32., 7400.|I. Belgyógyászati Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs.
authors.forename: Béla
authors.initials: B
authors.lastname: Hunyady
authors.affiliation: Transzplantációs és Sebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Gerlei
authors.affiliation: I. Belgyógyászat és Molekuláris Diagnosztikai Laboratórium, Szent György Egyetemi Oktató Kórház Székesfehérvár.
authors.forename: Judit
authors.initials: J
authors.lastname: Gervain
authors.affiliation: Hepatológiai Szakrendelés, Budapest és Budai Hepatológiai Centrum, Szent János Kórház és Észak-budai Egyesített Kórházak Budapest.
authors.forename: Gábor
authors.initials: G
authors.lastname: Horváth
authors.affiliation: II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Lengyel
authors.affiliation: I. Belgyógyászati Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar Pécs.
authors.forename: Alajos
authors.initials: A
authors.lastname: Pár
authors.affiliation: II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Péter
authors.affiliation: I. Belgyógyászati Osztály, MH Egészségügyi Központ Honvédkórház Budapest.
authors.forename: László
authors.initials: L
authors.lastname: Rókusz
authors.affiliation: Infektológia Osztály, Markusovszky Egyetemi Oktatókórház Szombathely.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Schneider
authors.affiliation: I. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Szalay
authors.affiliation: Orvos- és Egészségtudományi Centrum, Belgyógyászati Intézet, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen.
authors.forename: István
authors.initials: I
authors.lastname: Tornai
authors.affiliation: II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest.
authors.forename: Klára
authors.initials: K
authors.lastname: Werling
authors.affiliation: Egyesített Szent István és Szent László Kórház Budapest.
authors.forename: Mihály
authors.initials: M
authors.lastname: Makara
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D032921:Consensus; D004334:Drug Administration Schedule; D024882:Drug Resistance, Viral; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D006814:Hungary; D008103:Liver Cirrhosis / Q000517:prevention & control; D017093:Liver Failure / Q000517:prevention & control; D008113:Liver Neoplasms / Q000517:prevention & control; D008403:Mass Screening / Q000379:methods; D011480:Protease Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D011480:Protease Inhibitors
keywords: direct acting antiviral drug; direkt ható antivirális szer; genotype; genotípus; hepatitis C virus; hepatitis C-vírus; hepatocellular carcinoma; interferon; liver cirrhosis; májrák; májzsugor; polimerázgátló; polymerase inhibitor; protease inhibitor; proteázgátló; replication complex inhibitor; replikációskomplex-gátló; viral hepatitis; vírushepatitis