ABSTRACT
Hepatitis C is a major public health problem worldwide. This disease is caused by the hepatitis C virus, which is characterised by its genetic diversity. The infection is usually asymptomatic. However, between 60% and 80% of HCV-infected individuals will progress to chronic hepatitis, 20% to liver cirrhosis in the medium-to long-term and, each year, between 1% and 4% of these patients with cirrhosis will develop hepatocellular carcinoma (HCC). A Spanish consensus document has recently been drafted to diagnose hepatitis C in a single step, consisting of active investigation (antibodies and viremia) in a single sample, which according to the experts, would reduce the time to access treatment and avoid tracking losses. To definitively change the hepatitis C treatment paradigm, direct-acting antiviral drugs (DAAs) have been approved, whose development has been based on achieving cure rates close to 100% regardless of the genotype of the virus, ie, pangenotypes, with good tolerance and bioavailability. These drugs have constituted a real therapeutic revolution. Supplement information: This article is part of a supplement entitled «SEIMC External Quality Control Programme. Year 2016¼, which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, S.A. © 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosasy Microbiología Clínica. All rights reserved.
Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C/drug therapy , Hepacivirus/physiology , Hepatitis C/diagnosis , Hepatitis C/virology , HumansABSTRACT
La hepatitis C es un importante problema de salud pública a nivel mundial. Esta enfermedad está causada por el virus de la hepatitis C (VHC), virus que se caracteriza por su diversidad genética. La infección es generalmente asintomática, pero entre el 60 y el 80% de los infectados por el VHC evolucionarán a hepatitis crónica; el 20%, a medio-largo plazo, a cirrosis hepática, y entre el 1 y el 4% de estos pacientes con cirrosis van a desarrollar anualmente un carcinoma hepatocelular (CHC). Recientemente se ha elaborado un documento de consenso español para diagnosticar la hepatitis C en un solo paso que consiste en la investigación activa (anticuerpos y viremia) en una sola muestra, con lo que, a juicio de los expertos, disminuiría el tiempo de acceso al tratamiento y evitaría pérdidas de seguimiento. Con el objetivo de cambiar de forma definitiva el paradigma de tratamiento de la hepatitis C se han aprobado fármacos antivirales de acción directa (AAD) cuyo desarrollo se ha basado en lograr tasas de curación cercanas al 100%, independientemente del genotipo del virus, es decir, pangenotípicos, con buena tolerancia y biodisponibilidad. Estos fármacos representan una verdadera revolución terapéutica. Información sobre el suplemento: este artículo forma parte del suplemento titulado "Programa de Control de Calidad Externo SEIMC. Año 2016", que ha sido patrocinado por Roche, Vircell Microbiologists, Abbott Molecular y Francisco Soria Melguizo, S.A
Hepatitis C is a major public health problem worldwide. This disease is caused by the hepatitis C virus, which is characterised by its genetic diversity. The infection is usually asymptomatic. However, between 60% and 80% of HCV-infected individuals will progress to chronic hepatitis, 20% to liver cirrhosis in the medium-to long-term and, each year, between 1% and 4% of these patients with cirrhosis will develop hepatocellular carcinoma (HCC). A Spanish consensus document has recently been drafted to diagnose hepatitis C in a single step, consisting of active investigation (antibodies and viremia) in a single sample, which according to the experts, would reduce the time to access treatment and avoid tracking losses. To definitively change the hepatitis C treatment paradigm, direct-acting antiviral drugs (DAAs) have been approved, whose development has been based on achieving cure rates close to 100% regardless of the genotype of the virus, ie, pangenotypes, with good tolerance and bioavailability. These drugs have constituted a real therapeutic revolution. Supplement information: This article is part of a supplement entitled "SEIMC External Quality Control Programme. Year 2016" which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, SA
