Actualización terapéutica de la hepatitis C crónica

Abstract

Background: The prevalence of chronic hepatitis C (CHC) varies greatly, with rates in Southern Europe and the USA ranging from 1% to 3%, while in Egypt, it exceeds 20%; in England, it is 0.67%, and in India, it is 0.27%. This infection can lead to liver cirrhosis and hepatocellular carcinoma, resulting in approximately 500,000 annual deaths.

Objective: To describe the therapeutic update for chronic hepatitis C.

Methodology: A narrative literature review on CHC was conducted, gathering data from various databases, including Medline, Lilacs, TripDatabase, and Epistemonikos, based on the Scimago Journal Rank quality ranking.

Results: Direct-acting antivirals (DAAs) effectively treat CHC, demonstrating excellent virological response (greater than 90%) in different age groups and with comorbidities; however, their efficacy decreases in the presence of liver cirrhosis. It emphasizes strategies such as simplified testing and decentralized care —crucial for overcoming obstacles— along with person-centered interventions and the integration of services —to eliminate the virus—. Equitable access to therapies is challenging due to economic barriers and multidisciplinary approaches with robust health policies being required to move forward. Healthcare systems face challenges initiating treatment due to geographic obstacles, awareness, and stigma, which should be addressed with multifaceted strategies and multidisciplinary centers to achieve treatment adherence and success.

Conclusions: Despite the high effectiveness of DAAs in treating CHC, there are barriers originating from the healthcare system, healthcare providers, and patients that hinder screening, access, and continued treatment.