Hépato-Gastro & Oncologie Digestive


Management of hepatitis C: Challenges and perspectives Volume 23, supplement 1, Février 2016

Hôpital Haut-Lévêque,
service d’hépato-gastroentérologie et d’oncologie digestive,
Centre Expert Hépatites Virales Aquitaine,
33604 Pessac cedex
* Tirés à part.

With high effectiveness of treatments, sustained virological response after treatment of hepatitis C with direct antiviral agent can be achieved in nearly 100% of cases. Therefore, a treatment should be given to all infected patients with acute or chronic disease. Similarly, it is obvious that every screened patient should receive treatment. With this policy “test and treat”, the epidemiology of hepatitis C will necessarily evolve. Therefore, it is quite possible to imagine that hepatitis C could be a sporadic disease in France in 2025. Rigorous monitoring of the patient during and after treatment should be established. During treatment, adherence and drug interactions have to be assessed. After sustained virological response, the patient needs to be in a comprehensive care by supporting co-morbidities responsible for chronic liver diseases (alcohol, metabolic syndrome) and setting up a screening for hepatocellular carcinoma every six months by abdominal ultrasound. In patients with treatment failure through direct antiviral agent, the interest of research of resistance in the understanding of failure and selecting second-line treatment will have an essential place in the coming months.