A hepatitis C-vírus-fertőzés szűrése, diagnosztikája, antivirális terápiája, kezelés utáni gondozása. Magyar konszenzusajánlás. Érvényes: 2016. október 15-től
| Autor: | Ferenc Schneider, Zsuzsanna Gerlei, Gabriella Lengyel, László Rókusz, Klára Werling, Béla Hunyady, Zoltán Péter, Gábor Horváth, István Tornai, Mihály Makara, Ferenc Szalay, Judit Gervain, Alajos Pár |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry 030503 health policy & services Ribavirin General Medicine Guideline Hepatitis C medicine.disease 03 medical and health sciences Liver disease chemistry.chemical_compound 0302 clinical medicine chemistry Pegylated interferon medicine 030212 general & internal medicine 0305 other medical science Viral hepatitis Intensive care medicine business Contraindication Mass screening medicine.drug |
| Zdroj: | Orvosi Hetilap. 158:3-22 |
| ISSN: | 1788-6120 0030-6002 |
| DOI: | 10.1556/650.2017.30688 |
| Popis: | Treatment of hepatitis C is based on a national consensus guideline updated six-monthly according to local availability and affordability of approved therapies through a transparent allocation system in Hungary. This updated guideline incorporates some special new aspects, including recommendations for screening, diagnostics, use and allocation of novel direct acting antiviral agents. Indication of therapy in patients with no contraindication is based on demonstration of viral replication with consequent inflammation and/or fibrosis in the liver. Non-invasive methods (elastographies and biochemical methods) are preferred for liver fibrosis staging. The budget allocated for these patients is limited. Therefore, expensive novel direct acting antiviral combinations as first line treatment are reimbursed only, if the freely available, but less effective and more toxic pegylated interferon plus ribavirin dual therapy deemed to prone high chance of adverse events and/or low chance of cure. Priority is given to those with urgent need based on a pre-defined scoring system reflecting mainly the stage of the liver disease, but considering also additional factors, i.e., hepatic decompensation, other complications, activity and progression of liver disease, risk of transmission and other special issues. Approved treatments are restricted to the most cost-effective combinations based on the cost per sustained virological response value in different patient categories with consensus amongst treating physicians, the National Health Insurance Fund and patient’s organizations. Interferon-free treatments and shorter therapy durations are preferred. Orv. Hetil., 2017, 158(Suppl. 1), 3–22. |
| Databáze: | OpenAIRE |
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