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

Abstract:

PURPOSE OF REVIEW:Approximately 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 FINDINGS:Interferon-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. SUMMARY:There 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.

journal_name

Curr Opin HIV AIDS

authors

Cohn J,Roberts T,Amorosa V,Lemoine M,Hill A

doi

10.1097/COH.0000000000000180

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

369-73

issue

5

eissn

1746-630X

issn

1746-6318

journal_volume

10

pub_type

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