COMMENTARY

Hepatitis C: The Pace of Progress

Digestive Disease Week (DDW) 2013

William F. Balistreri, MD

Disclosures

June 06, 2013

In This Article

Barriers to Care Continue

Presentations here allow us to envision a multifaceted treatment scenario, which uses an antisense oligonucleotide perhaps in combination with other therapeutic agents: small interfering RNAs directed against conserved sequences in the viral protease replication complex or polymerase genes. The bottom line is that these exciting advances in antiviral therapy will lead to significant improvements in response rates and reduced adverse effects.

However, only a minority of HCV-infected patients may benefit because of multiple barriers which have been identified and which impede delivery of HCV therapy.

The study presented here reported perceived barriers to care.[11,12] Most surveyed physicians viewed patient-level barriers as highly significant. These include fear of the side effects and concerns about treatment duration and cost. Another barrier is inadequate case finding, an obstacle that could be overcome by widespread screening.

A report from the Centers for Disease Control and Prevention,[13] released last week, contained updated testing guidelines. The report states that many persons who test positive for hepatitis C do not receive the necessary follow-up to determine whether they require medical care. Therefore, enhanced efforts to improve awareness, education, and specialist availability are needed.

The high prevalence of HCV infection worldwide also should stimulate expanded efforts in primary prevention, including vaccine development, as well as aggressive approaches to secondary and tertiary prevention. These efforts will reduce the burden of chronic liver disease and improve survival.

Thank you for listening. This is Bill Balistreri for Medscape.

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