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Minerva Gastroenterologica e Dietologica 2016 March;62(1):63-75

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

The eradication of HCV

Stella DE NICOLA, Massimo COLOMBO ✉

Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy

Hepatitis C virus (HCV) infection is a major health problem that affects about 3% of the world’s population. Chronic infection can evolve into cirrhosis, end-stage liver disease and hepatocellular carcinoma. Since the discovery of the virus, great advances were made in its diagnostics and therapeutics. HCV has the peculiarity of being a curable infection, as persistent virus eradication can be achieved through therapy. The recent advent of direct-acting antiviral agents (DAAs), which can be combined to provide short and well-tolerated all-oral regimens, has allows higher rates of sustained viral response (SVR) for all HCV genotypes, also in patients previously considered as “difficult to treat” and in patients with advanced cirrhosis, in whom antiviral treatment was contraindicated in the past. While on the one hand this could make eradicating HCV a reality, still several other measures are necessary for this goal to be attained, including HCV-infected patients identification, broad access to therapy and need to target categories at highest risk of HCV infection and transmission. Ideally in the coming decades we would like to first control the disease by reducing morbidity and mortality, subsequently to reduce transmission and incidence to an acceptable level, and finally to achieve virus eradication worldwide. But this ideal progression requires a huge effort in terms of diagnosis, treatment and prevention of disease transmission.