Management of chronic hepatitis c virus infection: A consensus report of the study group for viral hepatitis of the Turkish society of clinical microbiology and infectious diseases

Abstract

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis C virus (HCV) infection, a global public health problem, affecting nearly 170 million people worldwide. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as epidemiology and natural history of HCV infection, economic burden of chronic hepatitis C (CHC), diagnosis of acute hepatitis C (AHC) and CHC, treatment of AHC, goals, endpoints, stopping rules and pre-therapeutic assessment of CHC therapy, indications for treatment, treatment of CHC, monitoring and managing treatment safety and side effects, measures to improve treatment adherence, posttreatment follow-up of patients who achieve a sustained virological response, contraindications to therapy, retreatment of non-sustained virological responders, follow-up of untreated patients and of patients with treatment failure, and prevention of HCV infection. Examples of some selected recommendations are as follows: [1] It should be kept in mind that approximately 75-85% of people who become infected will develop chronic HCV infection, up to 20% of them develop cirrhosis within 20 years, and the average annual risk of hepatocellular carcinoma among them is 1-4%. [2] In addition to the HCV RNA quantification, the HCV genotype should be assessed to provide relevant information with respect to treatment duration and different response rates prior to treatment initiation. [3] If predicted response rate is not appropriate to any of the existing regimens, the patient should be kept waited until alternative therapeutic options become available.