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Management of Untreated and Nonresponder Patients with Chronic Hepatitis C
- Source :
- Semin Liver Dis
- Publication Year :
- 2010
- Publisher :
- Georg Thieme Verlag KG, 2010.
-
Abstract
- Hepatitis C infection has evolved in the past quarter century from a newly recognized entity without a known pathogen (non-A, non-B hepatitis) to one of the world’s most prevalent causes of liver disease, an important source for hepatocellular carcinoma, and the major indication for liver transplantation. It is caused by a virus with a complex replication cycle that occurs in multiple genotypes, of which the four most prevalent (1, 2, 3, and 4) exhibit differences in clinical behavior and responses to therapy. Chronic hepatitis C virus (HCV) in particular has evolved from a disease with no known treatment to one with several primary treatment options, none of which is uniformly effective, and a growing list of secondary treatment options for those who have failed to respond to, or relapsed after initial therapy. As treatment is often associated with significant side effects, it is now a disease that presents clinicians with multiple important decisions: whom to treat, when and with what to treat them initially, and how to manage patients who have failed during initial therapy to achieve a sustained virological response, the gold standard of effective therapy. This review examines each of these important decisions, presenting evidence to help guide clinicians in their choices. The decisions are addressed sequentially as they arise during the initial evaluation and subsequent treatment of a typical, newly recognized patient with chronic HCV, and the considerations facing the clinician when the patient has failed to achieve an SVR.
- Subjects :
- Liver Cirrhosis
Male
medicine.medical_specialty
Alcohol Drinking
Genotype
Biopsy
medicine.medical_treatment
Decision Making
Hepacivirus
Interferon alpha-2
Liver transplantation
Virus Replication
Antiviral Agents
Deoxycytidine
Article
Polyethylene Glycols
Liver disease
Pharmacotherapy
Liver Function Tests
Ribavirin
medicine
Humans
Obesity
Treatment Failure
Practice Patterns, Physicians'
Intensive care medicine
Hepatitis
Hepatology
medicine.diagnostic_test
business.industry
Disease Management
Interferon-alpha
Hepatitis C
Hepatitis C, Chronic
Middle Aged
Viral Load
medicine.disease
Recombinant Proteins
Liver
Hepatocellular carcinoma
Retreatment
Immunology
Disease Progression
RNA, Viral
Drug Therapy, Combination
Liver function tests
business
Viral load
Subjects
Details
- ISSN :
- 10988971 and 02728087
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Seminars in Liver Disease
- Accession number :
- edsair.doi.dedup.....a8fdda083ad8e05b0da29e3d793e5bec