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Pathophysiology and Treatment of Hepatitis C

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Summary

Hepatitis C virus (HCV) infection is associated with a variable disease course and response to therapy. Some infected patients may develop little or no disease for 30 to 40 years, whereas others will develop cirrhosis within 5 to 10 years. Both host and viral factors influence the rate of disease progression.

The management of patients is determined by the severity of their disease assessed by liver biopsy. Those with mild hepatitis without fibrosis do not require treatment but should undergo liver biopsy every 3 years. Patients with mild hepatitis with fibrosis, or with moderate or severe hepatitis with or without fibrosis, should be offered treatment.

Interferon-α (IFNα) is currently the only licensed treatment for HCV infection. Although initial response rates to IFNα are high, over half the patients relapse and a sustained response is achieved in only 10 to 35% of patients. Higher doses of IFNα and a longer treatment duration are associated with better response rates. Treatment options for those who fail to respond to IFNα include a second course of IFNα at a higher dose or IFNα in combination with ribavirin, phlebotomy or ursodeoxycholic acid. At present, however, there are insufficient data to routinely recommend any of these options.

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  1. Liver Unit, Academic Department of Medicine, Imperial College School of Medicine, St Mary’s Hospital (QEQM Wing), South Wharf Road, London, W2 1NY, England

    H. C. Thomas, J. Booth & J. Brown

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Thomas, H.C., Booth, J. & Brown, J. Pathophysiology and Treatment of Hepatitis C. Drugs 52 (Suppl 2), 1–8 (1996). https://doi.org/10.2165/00003495-199600522-00003

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