Link to Pubmed [PMID] – 22154925
Presse Med 2012 Feb;41(2):146-52
The current treatment of chronic hepatitis C since several years, the association of pegylated interferon and ribavirine, allows to obtain a virological eradication in around 55% of patients, including 45% of those infected with the genotype 1. The cure, defined by an undetectable viremia 24 weeks after the discontinuation of treatment, is associated to an improvement of the prognosis of the patients with a decrease of mortality and morbidity. If the virologic recovery allows fibrosis regression, including cirrhosis reversal, why not to treat every HCV-infected patient? Because first therapy is not mandatory in all the patients (minim liver disease, co-morbidities which may be contraindications to therapy), second adverse events are frequent and may be severe, third costs are high (the antiviral treatment but also hematological growth factors…) and finally the treated patients do not recover constantly. This has resulted in personalized therapies based on the severity of the disease, the early viral kinetics, pharmacologic monitoring, genetic and immunological factors. In addition to these factors of personalization, the development of new anti-viral C molecules, the protease inhibitors (boceprevir or telaprevir which are about to be approved in combination with pegylated interferon and ribavirine) will allow to achieve a sustained virologic response in around 75% of cases.