Hepatitis C: A Paradigm Change. Actualization

Abstract

Hepatitis C is a important health problem worldwide (approximately 170-240 million persons infected, the most without knowing it). It is caused by the hepatitis C virus (6 genotypes) distributed worldwide and transmitted to human mainly through parenteral route. The infection is asymptomatic (85%) and its chronic phase produces cirrhosis, liver failure, extrahepatic symptoms, and liver cancer (80% of the cases). It is the principal cause of liver transplant in USA. The standard treatment (2001-2011) was pegylated Interferon and Ribavirin (48 weeks) with 40-50% RSV but with reduced tolerability and many side effects. In 2011, triple therapy (pegylated Interferon, Ribavirin, with Boceprevir or Telaprevir) in short treatments started, achieving RVS between 65-75%. In 2014, new drugs were approved by FDA (Sofosbuvir, Simeprevir, Ledispasvir, Dasabuvir, Ombistasvir, Daklastavir, Elbastasvir and Grazoprevir) used alone or combined with Ribavirin, with RVS 90-100%,.The early diagnosis and treatment is the best strategy to diminish the impact of the disease. The OMS objective is to eliminate the hepatitis C by the year 2030, although the lack of diagnosis and elevated drug prices will difficult to achieve the slogan “to test and treat as soon as possible”. In conclusion, there is scientific evidence to declare: hepatitis C is a curable disease.