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Significant advances in antiviral therapy with direct acting antivirals (DAAs) have transformed hepatitis C virus (HCV) treatment over the past four years (Table). We have achieved nearly every characteristic of an ideal regimen: pangenotypic, excellent safety and tolerability, high sustained virologic response (SVR), low pill burden, simplified dosing schedule, short treatment duration, and high genetic […]

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Chronic hepatitis C is the most common cause of hepatocellular carcinoma (HCC) in the United States and Europe. Antiviral therapy against hepatitis C virus (HCV) has long been regarded as one of the most effective chemopreventive strategies for HCC. Sustained viral response (SVR) in patients without cirrhosis can halt disease progression, thereby decreasing the risk […]

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In 2018, there is substantial evidence that hepatitis C virus (HCV) infection is a systemic disease associated with adverse clinical, economic, and patient-reported outcomes (PROs). Specifically, the clinical consequences of HCV infection can lead to both hepatic and extrahepatic manifestations. In this context, HCV infection increases the risk of liver-related and overall mortality. Additionally, HCV […]

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Chronic hepatitis C infection (HCV) is a major public health problem affecting more than 71 million patients worldwide including more than 3.5 million patients in the United States.1 With the introduction of direct acting antiviral agents (DAAs), it is now possible to cure hepatitis C infection even in patients with advanced fibrosis, cirrhosis and HCV […]

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Over 240 million people in the world are chronically infected with hepatitis B virus (HBV). In many infected individuals, initial infection leads to clearance (defined as the loss of surface antigen [HBsAg]). Some HBsAg negative individuals remain HBV DNA positive (i.e., occult HBV) and others have HBV DNA in the liver but are serologically cleared. […]

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The advent of direct acting antivirals (DAAs) in the treatment of chronic hepatitis C infection has been revolutionary in that they have drastically mitigated the side effects of therapy while enhancing efficacy relative to interferon-based therapy. DAAs are broadly categorized into the NS3/4A protease inhibitors, NS5A inhibitors, and the non-nucleoside and nucleotide NS5B inhibitors. Ribavirin, […]

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Evidence from a few randomized trials and multiple observational studies supports performing a liver ultrasound every six months as part of hepatocellular carcinoma (HCC) surveillance in patients with hepatitis C virus-related cirrhosis (HCVc). Although the possibility of using other technical modalities is tempting, there are concerns regarding radiation exposure and cost. Use of multiphase computed […]

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The availability of highly efficacious and tolerable all-oral direct acting antiviral (DAA) regimens for the treatment of chronic hepatitis C virus (HCV) infection in 2014 was met with a mix of joy and relief among both HCV providers and chronically infected patients. Finally we could do away with the low cure rates and toxicities associated […]

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The hepatitis C virus is primed to develop resistance to direct acting antiviral drugs (DAAs). This stems from several aspects of HCV biology including an extraordinary rate of viral turnover in infected individuals and the error-prone nature of the viral RNA dependent RNA polymerase. Assumptions based on these characteristics led to modeling studies that predicted […]

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The patient was a 55-year-old, young grandmother who said, I’ve tried them all, as I reviewed her HCV treatment history, which included interferon (IFN), pegylated IFN, consensus IFN and now maintenance IFN. She pulled up her pant legs and said, My real problem is here. Her lower legs had hyperpigmentation on them but no obvious […]