Treatment of chronic hepatitis C virus infection in Japan: update on therapy and guidelines
- PDF / 962,743 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 16 Downloads / 179 Views
REVIEW
Treatment of chronic hepatitis C virus infection in Japan: update on therapy and guidelines Kazuaki Chayama • C. Nelson Hayes Waka Ohishi • Yoshiiku Kawakami
•
Received: 4 November 2012 / Accepted: 4 November 2012 / Published online: 28 November 2012 Ó Springer Japan 2012
Abstract Hepatitis C virus (HCV) infection is a serious health problem leading to cirrhosis, liver failure and hepatocellular carcinoma. The recent introduction of telaprevir, which was approved in November 2011, in combination with peg-interferon and ribavirin is expected to markedly improve the eradication rate of the virus. However, side effects of triple therapy may be severe. In a phase three III clinical trial, 2250 mg of telaprevir, which is the same dosage used in clinical trials in Western countries, was given to Japanese patients. As this dosage is considered to be relatively high for Japanese patients, who typically have lower weight than patients in Western countries, reduction of telaprevir is recommended in the 2012 revision of the guidelines established by the Study Group for the Standardization of Treatment of Viral Hepatitis Including Cirrhosis published by the Ministry of Health,
K. Chayama C. N. Hayes Laboratory for Digestive Diseases, Center for Genomic Medicine, RIKEN, Hiroshima, Japan K. Chayama C. N. Hayes W. Ohishi Y. Kawakami Liver Research Project Center, Hiroshima University, Hiroshima, Japan K. Chayama (&) C. N. Hayes Y. Kawakami Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan e-mail: [email protected] W. Ohishi Department of Clinical Studies, Radiation Effects Research Foundation, Hiroshima, Japan
Labour and Welfare of Japan. Other protease inhibitors with fewer side effects are now in clinical trials in Japan. Alternatively, treatment of patients with combination of direct acting antivirals without interferon has been reported. In this review we summarize current treatment options in Japan and discuss how we treat patients with chronic HCV infection. Keywords Telaprevir Triple therapy Antiviral resistance Anemia Dose reduction Abbreviations HCV Hepatitis C virus DAAs Direct acting anti-virals SVR Sustained virological response RVR Rapid virological response
Introduction At least 1.5 million people in Japan and more than 200 million people worldwide are chronically infected with the hepatitis C virus [1, 2]. Due to an aging patient population, the health burden of chronic HCV infection in Japan is expected to increase over the next several decades [3]. Chronic infection develops in 60–80 % of symptomatic patients, leading to higher risk of cirrhosis, hepatocellular carcinoma, and end-stage liver disease. Chronic HCV infection is also one of the primary indications for liver transplantation [3], and ultimately 5–7 % of patients die from complications related to HCV infection [4–7]. The goal of HCV therapy is successful eradication of the virus
Data Loading...
