final program.qxd - Parallels Plesk Panel

OP 9.2
Improving anti-HCV therapy
Stanislas Pol, MD, PhD
Authors Affiliation
APHP, Hôpital Necker-Cochin, Unité d'hépatologie, Paris ; Université Paris Descartes,
Paris; INSERM U-567, Institut Cochin, Paris, France.
The estimated prevalence of hepatitis C virus (HCV) infection is 2% representing
123 million infected individuals worldwide. HCV-infection burdens public health in relation
with hepatic (cirrhosis in 20% of patients and its complications) and extra-hepatic
(vasculitis) complications and lessens quality of life. Major progresses have been made in
the last two decades for diagnosis and treatment of HCV including: 1. more appropriate
screening strategies for HCV infection (improved sensitivity of serological and virologic
tests); 2. a better evaluation of the liver impact of chronic HCV infection (semiquantitative
scoring systems of necro-inflammation and fibrosis on liver biopsy,
non-invasive evaluation of fibrosis with biochemical markers and elastometry); 3.
improved therapeutic regimens. They provide a better definition of: 1. who to treat
(clinical impact or significant fibrosis); 2. how to treat : tailoring therapies for doses and
durations of the pegylated interferon and ribavirin combination according to virologic
factors (mainly genotype and early viral kinetics, but also baseline viral load) and hosts
factors (fibrosis, immune status, weight...); 3. how to monitor efficacy and tolerance of
therapy. Progresses have now resulted in a 50% rate of complete HCV eradication
ranging from 45 to 90% according to the genotype and especially in those patients with
early viral response. New therapies, specific HCV protease or polymerase inhibitors, will
increase these encouraging results in a next future, in association with pegylated
interferon or more potent and less toxic new formulations of interferons or ribavirin.
Key words: Hepatitis C virus (HCV)/chronic hepatitis/cirrhosis/hepatocellular
carcinoma/Interferon/Ribavirin
ABSTRACTS
“ Focusing FIRST on PEOPLE “ 71 w w w . i s h e i d . c o m