تلخیص
Hepatitis C (HCV) affects millions in Pakistan. The disease is deadly, remains asymptomatic for number of years and leads to chronic hepatitis resulting in cirrhosis of the liver culminating in decompensation and ultimately can result in hepatocellular carcinoma and death. With more awareness in public, many more cases are being discovered.
With the advent of standard interferon in early 90s and soon later with ribavirin, the treatment became a reality. With introduction of pegylated interferon, in combination of ribavirin, the improvement in response became considerably better. With the advent of direct acting antiviral agents, which included telaprevir and boceprevir and later more recently simeprevir, the response became more improved, especially in genotype-I patients. Luckily, in Pakistan, the genotype-III is the commonly encountered genotype. However, some of the strains of genotype-III are rather resistant to currently available treatment.
With the recent introduction of protease inhibitors and polymerase inhibitors, there is a new page in the management of hepatitis C. Although, sofosbovir is being considered rather expensive even in US, in third world countries like Pakistan, the cost has been considerably lower. The response with recently approved sofosbovir along with ribavirin for genotype-I1,2 and genotype III patients.3 This has especially given a hope to those who have been unresponsive to interferon or have been intolerant or are ineligible because of cytopenias, in them the response has been very encouraging
Nasir Khokhar. (2014) Hepatitis C: is the cure near, , Volume-39, Issue-3.
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