Hepatitis C: the ongoing revolution

Doctors are advancing towards the cure of hepatitis C infection. Currently, 50% of patients may get rid of this virus by antiviral therapy. This rate should improve in the next few years.

Hepatitis C is a chronic inflammation of the liver caused by a virus. The disease results in various nonspecific symptoms, often extreme fatigue. But long term, patients are at risk of cirrhosis (20% of infected people) and more rarely liver cancer.

There are several types of viruses. About 60% of patients have genotype 1, and half of them can be cured by current therapy, but the specialists hope soon to reach 70% with new antiviral drugs.

The genotype 2 covers only 5% of patients, but 90% receive successful treatment. The genotype 3 (25% of patients) is associated with healing in 80% of cases. Andgenotype 4 (10% of patients) is healed in 50% of the cases.

Today, the treatment uses to pegylated interferon alpha (in the form of weekly injections), ribavirin tablets. For genotypes 2 and 3, it lasts six months and one year for the other two groups. Patients are initially treated for about four weeks. If a rapid response is observed biologically a very significant reduction in viral load, the recovery is very likely. If after three months, the improvement is insufficient, treatment should be stopped.

New antiviral test, the protease inhibitors, could improve the rate of healing Group 1 from 50 to 70%, with a triple combination with interferon and ribavirin.

These treatment is relatively heavy, with regular monitoring and not negligible side effects in hematologic and skin. Also psychological disorders, including anxiety in 20% of cases.

But healing sign is the final disappearance of the virus. For the future, many other therapeutic approaches are being explored to try to inhibit different stages of virus replication. The goal is to further improve the response to treatment, develop exclusively oral combination therapy and reduce side effects.

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