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The management of patients with mild hepatitis C

Journal Volume 68 - 2005
Issue Fasc.3 - Symposium
Author(s) C. Verslype, P. Michielsen, M. Adler, H. Orlent, D. Sprengers, J. Delwaide, F. D'Heygere, Ph. Langlet, R. Brenard, I. Colle, H. Reynaert, P. Stärkel, J. Henrion
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(1) Department of Hepatology, University Hospital Gasthuisberg, Leuven, Belgium ; (2) Department of Gastroenterology and Hepatology, University Hospital Antwerp, Belgium ; (3) Department of Gastroenterology and Hepatology, University Hospital Erasme, Brussels, Belgium ; (4) Department of Gastroenterology and Hepatology, AZ Sint-Janshospitaal, Brugge, Belgium; (5) Department of Gastroenterology and Hepatology, Sint-Augustinusziekenhuis, Antwerp, Belgium (6) Department of Gastroenterology and Hepatology, University Hospital, Liège, Belgium ; (7) Department of Gastroenterology and Hepatology, Groeninghe Hospital, Kortrijk, Belgium ; (8) Department of Gastroenterology and Hepatology, CHU Brugmann and CHIREC-Cavell, Brussels, Belgium ; (9) Department of Gastroenterology and Hepatology, Hôpital Saint-Joseph, Gilly, Belgium ; (10) Department of Gastroenterology and Hepatology, University Hospital Gent, Belgium ; (11) Department of Gastroenterology and Hepatology, University Hospital Free University of Brussels, Belgium ; (12) Department of Gastroenterology and Hepatology, University Hospital Saint-Luc, Brussels, Belgium ; (13) Department of Gastroenterology and Hepatology, Hôpital Jolimont, Haine-Saint-Paul, Belgium.

Infection with the hepatitis C virus (HCV) represents an impor- tant public health problem and is a leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Chronic hepati- tis C is a heterogeneous disease. Many patients have mild disease at presentation but not all of them will develop advanced liver dis- ease. However, the identification of these patients with mild hepati- tis C who will show progressive disease is difficult and is based on histological criteria and the assessment of co-factors (age, alcohol intake, steatosis). In addition, serum transaminases that are per- sistently normal on several occasions during 18 months may point to a more benign course. Patients with mild hepatitis C should not be excluded "a priori" from the possibility of being treated, as treatment with pegylated interferon and ribavirin is safe and effective in this group. Overall, the decision to initiate therapy should be individualized and based on the severity of the disease by liver biopsy, the potential of serious side effects, the probabili- ty of response and the motivation of the patient. (Acta gastro- enterol. belg., 2005, 68, 314-318).

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