Page 13 - The Flying Publisher Guide to Hepatitis C Treatment

Antiviral Therapy: The Basics
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1. Antiviral Therapy: The Basics
Simona Ruta, Costin Cernescu and Richard Sebastian Wanless
The hepatitis C epidemic is still growing in importance. While
the incidence of hepatitis C virus (HCV) infections is falling in
some countries, the burden of the disease arising from the pool
of chronic infections continues to rise. It has been estimated
that, by 2030, HCV will cause substantially higher morbidity and
mortality than HIV. Chronic Hepatitis C (CHC) occurs in 70% to
80% of those who contract the virus, 20% of whom will progress
to cirrhosis within 2-3 decades; a quarter of these will develop
decompensated liver disease, hepatocellular carcinoma (HCC)
and will need liver transplantation. A recent study has shown
that HCV infected persons have three times higher death rates
than those of age-matched general population (Brok 2010).
Excess mortality is due to both liver related causes and co-
morbidities and is related to age, treatment status, the degree of
fibrosis and mean alcohol consumption.
Antiviral therapy – Standard of Care (SoC)
According to all consensus guidelines (EASL 2011, NICE 2010,
AASLD 2009), the current standard of care (SoC) for CHC is the
combination of pegylated interferon alfa (PegIFN) and
ribavirin (RBV) for 24-48 weeks, depending on the viral
genotype.