Hepatitis C: Difference between revisions
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Direct acting antiviral (DAA) also called Specifically Targeted Antiviral Therapy for HCV (STAT-C) target HCV [[viral nonstructural protein]]s essential to replication and life of the virus. | Direct acting antiviral (DAA) also called Specifically Targeted Antiviral Therapy for HCV (STAT-C) target HCV [[viral nonstructural protein]]s essential to replication and life of the virus. | ||
====NS3 protease inhibitors==== | |||
{| class="wikitable" | {| class="wikitable" | ||
|+ [[Randomized controlled trial]]s of [[protease inhibitor]]s against the NS3/4A serine protease for hepatitis C genotype 1 infection. | |+ [[Randomized controlled trial]]s of [[protease inhibitor]]s against the NS3/4A serine protease for hepatitis C genotype 1 infection. | ||
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Two [[protease inhibitor]]s, [[telaprevir]] and [[boceprevir]] may add benefit to standard therapy of genotype 1 infection with peginterferon and ribavirin. [[Telaprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21696308">{{cite journal| author=Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al.| title=Telaprevir for retreatment of HCV infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2417-28 | pmid=21696308 | doi=10.1056/NEJMoa1013086 | pmc= | url= }} </ref> and untreated<ref name="pmid21696307">{{cite journal| author=Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al.| title=Telaprevir for previously untreated chronic hepatitis C virus infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2405-16 | pmid=21696307 | doi=10.1056/NEJMoa1012912 | pmc= | url= }} </ref> patients. [[Boceprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21449784">{{cite journal| author=Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al.| title=Boceprevir for previously treated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1207-17 | pmid=21449784 | doi=10.1056/NEJMoa1009482 | pmc= | url= }} </ref> and untreated<ref name="pmid21449783">{{cite journal| author=Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al.| title=Boceprevir for untreated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1195-206 | pmid=21449783 | doi=10.1056/NEJMoa1010494 | pmc= | url= }} </ref> patients. | Two NS3/4A serine [[protease inhibitor]]s, [[telaprevir]] and [[boceprevir]] may add benefit to standard therapy of genotype 1 infection with peginterferon and ribavirin. [[Telaprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21696308">{{cite journal| author=Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al.| title=Telaprevir for retreatment of HCV infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2417-28 | pmid=21696308 | doi=10.1056/NEJMoa1013086 | pmc= | url= }} </ref> and untreated<ref name="pmid21696307">{{cite journal| author=Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al.| title=Telaprevir for previously untreated chronic hepatitis C virus infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 25 | pages= 2405-16 | pmid=21696307 | doi=10.1056/NEJMoa1012912 | pmc= | url= }} </ref> patients. [[Boceprevir]] adds to peginterferon and ribavirin for previously treated<ref name="pmid21449784">{{cite journal| author=Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al.| title=Boceprevir for previously treated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1207-17 | pmid=21449784 | doi=10.1056/NEJMoa1009482 | pmc= | url= }} </ref> and untreated<ref name="pmid21449783">{{cite journal| author=Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al.| title=Boceprevir for untreated chronic HCV genotype 1 infection. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 13 | pages= 1195-206 | pmid=21449783 | doi=10.1056/NEJMoa1010494 | pmc= | url= }} </ref> patients. | ||
The NS3 protease inhibitor, [[asunaprevir]], might help treat hepatitis C.<ref name="pmid22256805">{{cite journal| author=Lok AS, Gardiner DF, Lawitz E, Martorell C, Everson GT, Ghalib R et al.| title=Preliminary study of two antiviral agents for hepatitis C genotype 1. | journal=N Engl J Med | year= 2012 | volume= 366 | issue= 3 | pages= 216-24 | pmid=22256805 | doi=10.1056/NEJMoa1104430 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22256805 }} </ref> | |||
==== NS5A replication complex inhibitors===== | |||
The NS5A replication complex inhibitor, [[daclatasvir]] , might help treat hepatitis C.<ref name="pmid22256805">{{cite journal| author=Lok AS, Gardiner DF, Lawitz E, Martorell C, Everson GT, Ghalib R et al.| title=Preliminary study of two antiviral agents for hepatitis C genotype 1. | journal=N Engl J Med | year= 2012 | volume= 366 | issue= 3 | pages= 216-24 | pmid=22256805 | doi=10.1056/NEJMoa1104430 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22256805 }} </ref> | |||
==Screening== | ==Screening== | ||
Revision as of 08:46, 13 October 2012
Hepatitis C is "inflammation of the liver in humans caused by hepatitis c virus, a single-stranded RNA virus. Its incubation period is 30-90 days. Hepatitis C is transmitted primarily by contaminated blood parenterally, and is often associated with transfusion and intravenous drug abuse. However, in a significant number of cases, the source of hepatitis C infection is unknown."[1]
Treatment
Direct acting antiviral (DAA)
Direct acting antiviral (DAA) also called Specifically Targeted Antiviral Therapy for HCV (STAT-C) target HCV viral nonstructural proteins essential to replication and life of the virus.
NS3 protease inhibitors
| Trial | Patients | Intervention | Comparison | Outcome | Results | |
|---|---|---|---|---|---|---|
| Intervention | Control | |||||
| ADVANCE Study[2] 2011 |
Previously untreated patients | telaprevir | peginterferon-ribavirin | HCV RNA 24 weeks after last treatment | 69% to 75% | 44% |
| REALIZE Study[3] 2011 |
Previously treated patients | telaprevir | peginterferon-ribavirin | HCV RNA 24 weeks after last treatment | 83% to 88% (prior reponse) 54% to 59% (prior partial response) 29% to 33% (prior non-response) |
24% (prior reponse) 15% (prior partial response) 5% (prior non-response) |
| SPRINT-2 study[4] 2011 |
Previously untreated patients | boceprevir | peginterferon-ribavirin | HCV RNA level | 59% to 66% | 21% |
| HCV RESPOND-2 study[5] 2011 |
Previously treated patients | boceprevir | peginterferon-ribavirin | HCV RNA level | 67% to 68% (nonblack patients) 42% to 53% (black patients) |
40% (nonblack patients) 23% (black patients) |
Two NS3/4A serine protease inhibitors, telaprevir and boceprevir may add benefit to standard therapy of genotype 1 infection with peginterferon and ribavirin. Telaprevir adds to peginterferon and ribavirin for previously treated[2] and untreated[3] patients. Boceprevir adds to peginterferon and ribavirin for previously treated[5] and untreated[4] patients.
The NS3 protease inhibitor, asunaprevir, might help treat hepatitis C.[6]
NS5A replication complex inhibitors=
The NS5A replication complex inhibitor, daclatasvir , might help treat hepatitis C.[6]
Screening
The United States Centers for Disease Control and Prevention issued draft recommendation for screening individuals born between 1945 and 1965.[7]
References
- ↑ Anonymous (2024), Hepatitis C (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 2.2 Zeuzem S, Andreone P, Pol S, Lawitz E, Diago M, Roberts S et al. (2011). "Telaprevir for retreatment of HCV infection.". N Engl J Med 364 (25): 2417-28. DOI:10.1056/NEJMoa1013086. PMID 21696308. Research Blogging.
- ↑ 3.0 3.1 3.2 Jacobson IM, McHutchison JG, Dusheiko G, Di Bisceglie AM, Reddy KR, Bzowej NH et al. (2011). "Telaprevir for previously untreated chronic hepatitis C virus infection.". N Engl J Med 364 (25): 2405-16. DOI:10.1056/NEJMoa1012912. PMID 21696307. Research Blogging.
- ↑ 4.0 4.1 4.2 Poordad F, McCone J, Bacon BR, Bruno S, Manns MP, Sulkowski MS et al. (2011). "Boceprevir for untreated chronic HCV genotype 1 infection.". N Engl J Med 364 (13): 1195-206. DOI:10.1056/NEJMoa1010494. PMID 21449783. Research Blogging.
- ↑ 5.0 5.1 5.2 Bacon BR, Gordon SC, Lawitz E, Marcellin P, Vierling JM, Zeuzem S et al. (2011). "Boceprevir for previously treated chronic HCV genotype 1 infection.". N Engl J Med 364 (13): 1207-17. DOI:10.1056/NEJMoa1009482. PMID 21449784. Research Blogging.
- ↑ 6.0 6.1 Lok AS, Gardiner DF, Lawitz E, Martorell C, Everson GT, Ghalib R et al. (2012). "Preliminary study of two antiviral agents for hepatitis C genotype 1.". N Engl J Med 366 (3): 216-24. DOI:10.1056/NEJMoa1104430. PMID 22256805. Research Blogging.
- ↑ Centers for Disease Control and Prevention (2012) CDC Announces First Ever National Hepatitis Testing Day and Proposes that All Baby Boomers Be Tested Once for Hepatitis C