Management Of Hepatitis C

In the past few years, remarkable progress has been made in our understanding of HCV biology, pathogenesis of infection, and structure-function relationships. This has led to quantum advances in clinical efficacy and tolerability. Yet, in spite of this amazing progress, there remain obstacles to widespread successful treatment. These issues include biological failures even with direct-acting agents, lack of options for individual with organ failures, drug-drug interactions, access to medications either due to lack of availability or affordability, and psychiatric and social issues. These problems are likely to remain in the future. Therefore, this book has been created by distinguished faculties from around the world to address the progress in our understanding of HCV infection and to review new treatment options, limitations, and accessibility of new therapeutic options.

This book presents a comprehensive collection of classic cases and problem scenarios encountered as bedside case discussions during ward rounds. It facilitates the practical management of hepatic disorders. The unique aspect of hepatology involves the blend of the basic tenet of clinical medicine applied to liver disease and a multitude of interventional modalities in the management of liver, biliary, and pancreatic diseases. This book takes the reader through the process of ruling in and ruling out possibilities based on clinical data (history and examination) and then traces the logical trajectory of each case from recommended investigations to the analysis of test results and finally to making a syndromic diagnosis. By adopting an evidence-based approach, the book emphasizes analytical and need-based studies to exclude any mimics. This book helps practice hepatologists and gastroenterologists for a systematic approach towards the most common cases.

Clinical information about Hepatitis C is quickly outdated, so Dr. Poordad has assembled expert authors to provide state-of-the-art clinjcal reviews for hepatologists. This issue is uniquely organized to present articles based on therapeutic regimens for certain types of patients: Regimens for the Treatment-Naïve Patient; Regimens for Treatment of the Interferon-Failure Patient; Regimens for DAA Failure Patients; Regimens for the Cirrhotic Patient; Regimens for the Peri-Transplant Patient; Regimens for the HIV-Co-Infected Patient; and Next-generation Regimens: The Future of HCV Therapy. This presentation will be very clinically relevant for the practicing hepatologist.

Hepatitis B and C cause most cases of hepatitis in the United States and the world. The two diseases account for about a million deaths a year and 78 percent of world's hepatocellular carcinoma and more than half of all fatal cirrhosis. In 2013 viral hepatitis, of which hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common types, surpassed HIV and AIDS to become the seventh leading cause of death worldwide. The world now has the tools to prevent hepatitis B and cure hepatitis C. Perfect vaccination could eradicate HBV, but it would take two generations at least. In the meantime, there is no cure for the millions of people already infected. Conversely, there is no vaccine for HCV, but new direct-acting antivirals can cure 95 percent of chronic infections, though these drugs are unlikely to reach all chronically-infected people anytime soon. This report, the first of two, examines the feasibility of hepatitis B and C elimination in the United States and identifies critical success factors. The phase two report will outline a strategy for meeting the elimination goals discussed in this report.

Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to receive the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviors and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination. These are the first WHO guidelines on testing for chronic HBV and HCV infection and complement published guidance by WHO on the prevention, care and treatment of chronic hepatitis C and hepatitis B infection. These guidelines outline the public health approach to strengthening and expanding current testing practices for HBV and HCV, and are intended for use across age groups and populations.

Chronic Hepatitis C Virus: Lessons from the Past, Promise for the Future documents the monumental advances that have been made in our understanding of chronic HCV during the past decade. The first section reviews the natural history of chronic HCV, how this virus can affect other organs in addition to the liver, and whether treating chronic HCV alters the natural history of this disease. Section 2 reviews the advances that have been made in the treatment of chronic HCV during the past decade with interferon based therapy. Separate chapters on response guided therapy and how to manage the adverse events associated with these medications provide the physician with the concepts required to more effectively treat chronic HCV now and in the future. As the genetics of virologic response have recently been elucidated, a chapter is devoted to helping the clinician understand how genes that modulate disease processes and their treatment are identified and utilized in clinical care. Section 3 deals with the future of HCV treatment and specific inhibitors of HCV. Specific chapters explain how targets for drugs are identified and how drugs are then developed and tested; how mutations of HCV develop and how anti-viral agents will affect this process; the most up to date data regarding the treatment of chronic HCV with peginterferon, ribavirin and anti-viral agents; and the potential to treat chronic HCV with just oral anti-viral agents and without peginterferon and ribavirin in the future. The final section of this book covers issues related to liver transplantation in patients with chronic HCV. Separate chapters review the natural history of chronic HCV in liver transplant recipients and the impact of utilizing HCV positive donors. The volume concludes with chapters that cover the treatment of chronic HCV both prior to and after liver transplantation with potent anti-viral agents. Chronic Hepatitis C Virus: Lessons from the Past, Promise for the Future is a valuable resource for all physicians caring for patients with chronic HCV.