Modern modes of chronic hepatitis C treatment
Abstract
The aim of review. To highlight up-to-date modes of chronic hepatitis C treatment.
Original positions. Nowadays conventional «gold standard» treatment of chronic HCV-infection is antiviral therapy by pegilated interferon and ribavirin combination. Recently principles of antiviral treatment were seriously reconsidered, that inevitably leads to sophistication of therapeutic algorithms. So, modification of treatment mode according to virologic response is rational today. In near-term prospect addition of the third agent — protease inhibitor to the standard combination treatment mode will become possible soon. Published results of large investigations prove significantly higher efficacy of triple therapeutic mode in patients with the 1-st hepatitis C virus genotype, that opens new wide perspectives in treatment of these patients.
Conclusion. Recently individual approach to treatment of patients with chronic HCV-infection becomes more actual. In particular, the algorithm of therapeutic mode modification according to virologic response to treatment at the specific patient is developed. In some cases it enables reduction of treatment terms, decrease of cost and increase of patient’s compliance. Moreover, in the close perspective new antiviral agents - protease inhibitors will appear at the market, that allows to increase antiviral treatment efficacy in patients with the 1-st hepatitis C virus genotype.
About the Authors
V. T. Ivashkin
ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздравсоцразвития РФ
Russian Federation
Russian Federation
M. V. Mayevskaya
ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздравсоцразвития РФ
Russian Federation
Russian Federation
M. A. Morozova
ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздравсоцразвития РФ
Russian Federation
Russian Federation
Ye. O. Lyusina
ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздравсоцразвития РФ
Russian Federation
Russian Federation
References
1. Ивашкин В.Т. Иммунная система и повреждения печени при хронических гепатитах В и С. Рос журн гастроэнтерол гепатол колопроктол. 2009; 19(6):4–10.
2. Ivashkin V.T. Immune system and liver damages at chronic B and C hepatites. Ros zhurn gastroenterol hepatol coloproctol. 2009; 19 (6):4–10.
3. Никитин И.Г. Противовирусная терапия хронического гепатита С: современное состояние проблемы и перспективы. Best Сlinical Practice. Русское изд. 2011; 5:3–12.
4. Nikitin I.G. Antiviral therapy of chronic hepatitis C: state-of-the-art and prospects. Best Сlinical Practice. Russian ed. 2011; 5:3–12.
5. Anand B, Currie S, Dieperink E, et al. Alcohol use and treatment of hepatitis C virus: results of a national multicenter study. Gastroenterology. 2006; 130:1607–16.
6. Berg T, Sarrazin C, Herrmann E, et al. Prediction of treatment outcome in patients with chronic hepatitis C: significance of baseline parameters and viral dynamics during therapy. Hepatology. 2003; 37:600–9.
7. Davis G, Wong J, Mc Hutchison J, et al. Early virologic response to treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C. Hepatology. 2003; 38:645–52.
8. De Bruijne J, Buster E, Gelderblom H, et al. Treatment of chronic hepatitis C virus infection – Dutch national guidelines. Netherlands J Med. 2008; 66:311–22.
9. Deuffic-Burban S, Babany G, Lonjon-Domanec I, et al. Impact of pegylated interferon and ribavirin on morbidity and mortality in patients with chronic hepatitis C and normal aminotransferases in France. Hepatology. 2009; 50:1351–59.
10. EASL Clinical Practice Guidelines: Management of hepatitis C virus infection. European Association for the Study of the Liver. J Hepatol. 2011; 55:245–64.
11. Ghany G, Nelson D, Strader D, et al. Updated treatment guidelines genotype 1 chronic HCV infection. Hepatology. 2011; 54(4):1433–44.
12. Italian Association for the study of the liver, Italian Society of infectious td, Italian Society for the study of sexually transmitted diseases. Practice guidelines for the treatment of hepatits C: recommendations from AISF/ SIMIT/SIMAST. Dig Liver Dis. 2010; 42:81–91.
13. Jacobson I, McHutchison J, Dusheiko G, et al. Telaprevir for previously untreated chronic hepatitis C virus infection. N Engl J Med. 2011; 364:2405–16.
14. Kenneth E. Sherman, Steven L. Flamm, Nezam H. Afdhal et al. Response-guided telaprevir combination treatment for hepatitis C virus infection. N Engl J Med. 2011; 365:1014–24.
15. Manns MP, Wedemeyer H, Cornberg M. Treating viral hepatitis C: efficacy, side effects, and complications. Gut. 2006; 55:1350–9.
16. McCaughan GW. Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis, management and treatment of hepatitis C virus infection. J Gastroenterol Hepatol. 2007; 22:615–33.
17. McHutchison J, Lawitz E, Shiffman M, et al. Peginterferon alfa-2b or alfa-2a with ribavirin for treatment of hepatitis C infection. New Engl J Med. 2009; 361:580– 93.
18. Moradpour D, Penin F, Rice C. Replication of hepatitis C virus. Nat Rev Microbiol. 2007; 5:453–63.
19. Pawlotsky JM. The results of Phase III clinical trials with telaprevir and boceprevir presented at the Liver Meeting 2010: a new standard of care for hepatitis C virus genotype 1 infection, but with issues still pending. Gastroenterology. 2011; 141(2):778.
20. Poordad F, McCone J, Bacon B, et al. Boceprevir for untreated chronic HCV genotype 1 infection. N Engl J Med. 2011; 364(13):1195–206.
21. Romero-Gomez M, Andrade R, Salmeron J, et al. Insulin resistance impairs sustained response rate to peginterferon plus ribavirin in chronic hepatitis C patients. Gastroenterology. 2005; 128:636–41.
22. Sarrazin C, Berg T, Ross R, et al. Prophylaxis, diagnosis and therapy of hepatitis C virus (HCV) infection: the German guidelines on the management of HCV infection. Z Gastroenterol. 2010; 48:289–351.
23. Sarrazin C, Susser S, Doehring A, et al. Importance of IL28B gene polymorphisms in hepatitis C virus genotype 2 and 3 infected patients. J Hepatol. 2011; 54:415–21.
24. Zeuzem S, Andreone P, Pol S, Lawitz E. Telaprevir for retreatment of HCV infection. N Engl J Med. 2011;
25. :2417–28.
Review
For citations:
Ivashkin V.T., Mayevskaya M.V., Morozova M.A., Lyusina Ye.O. Modern modes of chronic hepatitis C treatment. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012;22(1):36-44. (In Russ.)
Views:
125
Email this article 
