Therapeutic approach of chronic hepatitis C

Chronic infection from the hepatitis C virus (HCV) is one of the most common infectious diseases worldwide. It is estimated that more than 170 million people worldwide are infected by HCV. HCV is responsible for the 70% of cases of chronic hepatitis, the 60% of cases of hepatocellular cancer and the 30% of liver transplantations. Therapy of chronic infection from the HCV aims to the: a) eradication of the virus from liver and blood and sustenance of undetectable serum HCV-RNA after the end of the treatment and b) stabilization or improvement of liver histological status. In 80’ physicians treated chronic hepatitis C by using interferon alpha (IFN-α), whereas few years later they added ribavirin to the treatment. The combination therapy of IFN-α and ribavirin had had better results, but many patients left untreated. In 90’ IFN-α was replaced by pegylated interferon alpha (PEG-IFN-α), with or without the use of ribavirin. In this study the following questions are answered: a) which patients should be treated? b) what are the appropriate clinical and laboratory tests before treatment? c) which is the most effective therapeutic scheme and which is its duration? and d) which is the appropriate surveillance of the patients, especially after the end of the treatment? Additionally, there are mentioned the most common adverse effects of interferon and ribavirin treatment, which are in many cases the cause of altering the treatment

Keywords: Chronic hepatitis C, Interferon, Ribavirin