Simplified diagnostic monitoring for hepatitis C, in the new era of direct-acting antiviral treatment

被引:26
|
作者
Cohn, Jennifer [1 ,2 ]
Roberts, Teri [2 ]
Amorosa, Valerianna [3 ]
Lemoine, Maud [4 ]
Hill, Andrew [5 ]
机构
[1] Univ Penn, Div Infect Dis, Rue Lausanne 78, CH-1202 Geneva, Switzerland
[2] Med Sans Frontieres, Geneva, Switzerland
[3] Univ Penn, Div Infect Dis, Philadelphia, PA 19104 USA
[4] Univ London Imperial Coll Sci Technol & Med, St Marys Hosp, Dept Hepatol, London, England
[5] Univ Liverpool, Dept Pharmacol & Therapeut, Liverpool L69 3BX, Merseyside, England
基金
美国国家卫生研究院;
关键词
access; diagnosis; hepatitis C virus; scale up; simplification; TESTS;
D O I
10.1097/COH.0000000000000180
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Purpose of reviewApproximately 150-175 million people are infected with hepatitis C virus (HCV). Until very recently, the complexity, cost and poor efficacy and tolerability of pegylated interferon and ribavirin (PEG-RBV) treatment have hindered scale up in low-income and middle-income countries (L&MICs). Similarly, the diagnostic and monitoring algorithm associated with PEG-RBV has been expensive and complicated because of the poor efficacy and frequency of adverse drug effects of PEG-RBV therapy. This article provides an overview of the potential changes to the diagnosis and monitoring algorithm and describes key promising tools in the diagnostics pipeline.Recent findingsInterferon-free direct-acting antiviral (DAA) therapy sets the stage to significantly simplify laboratory requirements and make the overall diagnostic package much less expensive. Diagnostic simplification and cost-reduction will be key to enable implementation of HCV screening and treatment in L&MICs.SummaryThere is the potential to introduce simplified monitoring for hepatitis C. Antigen testing could be used as a replacement for HCV RNA PCR tests, to establish active infection and then to prove cure after stopping DAA treatment. If new DAA treatments can be shown to be pan-genotypic, genotyping may no longer be required.
引用
收藏
页码:369 / 373
页数:5
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