Chronic Hepatitis C Treatment: A Systematic Review | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 3, Volume 67, Issue 1, April 2017, Page 305-313 PDF (362.83 K) | ||||
| Document Type: Original Article | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Aishah Mohammed Alenezi1; Abdulaziz Hassan Mohammed Al-Fakih2; Sultan Mohammed Al-Afif2; Abdulkarem Mohammed Al-Afif2; Bashayer Abbas Habib3 | ||||
| 1Northern Border University | ||||
| 2Hadhramout University | ||||
| 3Almaarefa Colleges | ||||
| Abstract | ||||
| Background: Chronic hepatitis C (CHC) infection affects almost 3% of the global population and can lead to cirrhosis, liver failure, and hepatocellular carcinoma in a significant number of those infected. Thus, there is a complelling need to develop and introduce new therapeutics with a direct-acting antiviral effect in order to target various stages of the HCV lifecycle for HCV eradication without concomitant interferon. Study Objective: to provide treatment recommendations for chronic HCV for specialists and generalists based on published evidence. Methods: A literature search of Web of Science, Scopus, Embase, Agricola, Cochrane Library, Cinahl Plus, Google Scholar, and Oaister was conducted from 1990 to 2016, records were filtered according to the Inclusion criteria and 27 hits were yielded. Results: Hepatitis C virus genotype 1 is more difficult to cure than genotype 2 or genotype 3. Patients with HCV genotype 1 should receive treatment with sofosbuvir + pegylated interferon + ribavirin because of the shorter duration of therapy and high rates of SVR (89%-90%). Simeprevir + pegylated interferon + ribavirin is an alternative for patients with HCV genotype 1 (SVR, 79%-86%). Patients with HCV genotypes 2 and 3 should receive therapy with sofosbuvir + ribavirin alone (SVR for genotype 2, 12 weeks’ duration: 82%-93%; SVR for genotype 3, 24 weeks’ duration, 80%-95%). Patients with HIV-HCV coinfection and patients with compensated cirrhosis (ie, cirrhosis but preserved synthetic liver function) should receive the same treatment as HCV-monoinfected patients. Conclusion: A growing body of evidence suggests that recently developed HCV combined treatment modalities have transformed chronic HCV into a routinely curable disease being relatively available and well tolerated ,which can potentially reduce the need for liver transplantation and reduce HCV-related mortality. Treatment protocol for genotype1 is based on a combined regimen of Pegylated interferons with ribavirin and sofosbuvir or simeprevir while Sofosbuvir with ribavirin alone should be used to treat patients infected with HCV genotypes 2 and 3. Patients coinfected with human immunodefiency virus and HCV genotype 1 should be treated for HCV with pegylated interferons, ribavirin, and sofosbuvir by a physician with experience in treating this particular group of patients and familiar with potential drug interactions. | ||||
| Keywords | ||||
| hepatitis C; Treatment; SVR; HCV genotype; simeprevir; Ribavirin | ||||
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