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). Nonetheless, a fourfold increase in persons with chronic hepatitis C infection is projected over the next decade, 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.

"However, the good news is that new combination therapies are having a beneficial impact on this disease," noted panel chair Dr. James Boyer, Ensign Professor of Medicine and Director 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. Up to 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."

More than 4 million Americans are infected with hepatitis C, and of this group, the majority experience chronic infection, defined as detection of the virus in blood over at least a 6-month period. The hepatitis C virus (HCV) is the most common blood-borne infection, and 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 (SVR) than monotherapy or standard interferon-ribavirin combina

Contact: Kelli Marciel
NIH/Office of the Director

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