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 23 November 2017

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News

Progress and future directions for management of hepatitis C

Substantial advances in treatment for chronic hepatitis C and a decline in the number of new infections were highlighted by a panel convened by the National Institutes of Health (NIH).

News image

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The independent, non-advocate, non-Federal panel issued its statement at the conclusion of a 3-day NIH Consensus Development Conference on Management of Hepatitis C: 2002, held on the NIH campus in Bethesda, Maryland, USA.

Despite these positive findings, a 4-fold increase in persons with chronic hepatitis C infection is projected over the next decade.

This will be as a result of unsuspected infection from contaminated blood and blood products, occupational exposure, and injection drug use prior to the advent of routine screening in the early 1990s.

These chronic infections are now leading to significant increases in cirrhosis, end-stage liver disease, liver cancer, and are the most common causes of liver transplants.

"The good news is that new combination therapies are having a beneficial impact on this disease," noted panel chair Dr James Boyer, of the Liver Center at Yale University School of Medicine.

"In addition, preliminary research indicates that this approach may prove useful in treating important subgroups of patients, including children and injection drug users, previously ineligible for treatment.

4-fold increase in chronic hepatitis C infection expected over next decade.
NIH
"Up until now, the majority of studies have focused on what is actually a narrow segment of the patient population. Thus, we still have a lot to learn."

The hepatitis C virus (HCV) is the most common blood-borne infection. Transmission now occurs primarily by injection drug use, high-risk sexual behaviors and occupational exposures such as accidental needle sticks, and mother-to-infant transmission.

Clinical trials are providing persuasive evidence that treating HCV with a combination of pegylated interferon and ribavirin produces a considerably better sustained viral response than monotherapy or standard interferon-ribavirin combination.

The consensus panel has recommended that the scope of patients eligible for treatment should be expanded, to include those who use injected drugs, consume alcohol, suffer from co-morbid conditions such as depression, or who are coinfected with HIV.

Similarly, panelists cautioned against the exclusion of children and older adults from treatment and further research.

The panel has also made several recommendations for future research.

The full text of the panel's statement is available in draft form by clicking here.

NIH
14 June 2002

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