New Therapies for Treating Hepatitis C Virus: Impact on Laboratory Testing Recommendations and Clinical Management
| Autor: | Gary L. Horowitz, Nicole V. Tolan, Camilla S. Graham, David R. Hillyard, William O. Osburn, Stuart C. Ray |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Cirrhosis business.industry medicine.medical_treatment Hepatitis C virus Biochemistry (medical) Clinical Biochemistry Disease Hepatitis C Liver transplantation medicine.disease medicine.disease_cause Asymptomatic 03 medical and health sciences Chronic infection 030104 developmental biology Hepatocellular carcinoma Internal medicine Immunology medicine medicine.symptom business |
| Zdroj: | Clinical Chemistry. 63:1799-1805 |
| ISSN: | 1530-8561 0009-9147 |
| Popis: | Hepatitis C infection affects close to 150 million people worldwide. In the US, it is estimated that as many as 5 million people have been infected with the hepatitis C virus (HCV),7 many of whom are unaware of their infection. Some individuals clear the infection on their own, but the overwhelming majority of patients (approximately 75%) develop chronic infection, which can be asymptomatic for many years. Ultimately, chronic HCV infection can lead to cirrhosis, and potentially liver failure and hepatocellular carcinoma. In the US, HCV is now the most common indication for liver transplantation, and it accounts for more deaths each year than all other reportable infectious diseases combined, including HIV. The latest generation of direct-acting antivirals (DAA) has the potential to cure the disease in at least 95% of patients. Although the cost of these medications is slowly declining, they are still expensive (∼$30000–$100 000 per case), and states have varying health-care coverage limitations as to who can be treated. That said, the first step in eliminating the virus is identifying those with infection. To this end, the CDC has recommended one-time baby-boomer cohort screening as the prevalence of infection is highest in those born between 1945–1965. More recently, we have seen an increase in the rate of infection in individuals 20–40 years of age, which has been associated with increased injection drug use in the current US opioid epidemic. The currently recommended laboratory testing algorithm involves first screening for HCV antibodies (HCV Ab) via immunoassay. For those patients with positive HCV Ab results, follow-up HCV RNA testing is necessary to differentiate those who have spontaneously cleared the infection from those who have become chronically infected and need further medical care. Studies have shown that, even with a successful screening program, many patients do not get the necessary … |
| Databáze: | OpenAIRE |
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