Comparison of Guidelines for Management of Chronic Hepatitis C

Kim, Kyung Ah

Abstract

Therapeutic options for patients with hepatitis C virus infection have evolved substantially with the advent of highly effective direct-acting antiviral agents (DAA). Guidelines for treatment of hepatitis C have changed with the evolution of hepatitis C treatments. However, it differs considerably among nations, as the approval and availability of new DAAs, cost-effectiveness, socioeconomic status, and timing of guideline revisions vary. Guidelines for management of hepatitis C by the Korean Association for the Study of the Liver, which was established in November 2013, recommend response-guided therapy with combination of peg-interferon-alpha and ribavirin (PR). Recommendations for testing, managing, and treating hepatitis C by the American Association for the Study of Liver Disease, which was established in January 2014 and keeps updated, recommend the combination therapy including new DAAs such as sofosbuvir, ledipasvir/sofosbuvir, simeprevir and ritonavir-boosted paritaprevir/ombitasvir/dasabuvir, and discourage use of PR with or without a first-generation protease inhibitor. The European Association of the Study of the Liver recommendations for treatment of hepatitis C revised in April 2015 suggest combination therapy, including new DAAs, such as sofosbuvir, ledipasvir/sofosbuvir, simeprevir, daclatasvir, and ritonavir-boosted paritaprevir/ombitasvir/dasabuvir. Guidelines for treating hepatitis C will be changing soon in Korea with the approval and release of new DAAs.