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Minerva Medica 2020 Dec 15

DOI: 10.23736/S0026-4806.20.07208-0


language: English

Hepatitis C: clinical management and debated issues

Stefano GITTO 1, Carmela CURSARO 2, Alessandra BARTOLI 2, Marzia MARGOTTI 2, Pietro ANDREONE 2

1 Internal Medicine and Liver Unit, University Hospital Careggi, Florence, Italy; 2 Internal and Metabolic Medicine, AOU di Modena and University of Modena and Reggio Emilia, Modena, Italy


Hepatitis C virus represents an important global health issue with 71 million of infected people in the word. Direct-acting antivirals are quite new molecules that hit specific Hepatitis C virus proteins useful for viral replication and assembly. Notably, Direct-acting antivirals bring to high sustained virological response rates showing also a great safety profile. This treatment revolution had an impact on transplantation world, in fact the number of liver transplants due to Hepatitis C virusrelated cirrhosis and hepatocellular carcinoma is quickly decreasing. Even if this therapy has achieved excellent results in terms of morbility and mortality rates’ reduction, there are some debated issues to consider. In the present review the main clinical challenges in every-day management of Hepatitis C virus patients treated with Direct-acting antivirals and the debated effects of viral clearance (metabolic, cardiovascular, immunologic and neoplastic) are discussed. The detection of barriers that can preclude the delivery of Hepatitis C virus care, is the most complex challenge for the scientific community. To obtain the Hepatitis C virus global eradication by 2030, as the World Health Organisation has set, will be complex and laborious and will need a further multilevel effort.

KEY WORDS: Hepatitis C; Chronic hepatitis C; Direct-acting antivirals; Sustained virological response; Viral resistance

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