Hepatitis C

General
Around 71 million throughout the world people have been infected with hepatitis C. The lowest prevalences are found in Western Europe and North America (1%). The Netherlands is considered a low endemic country, with an estimated prevalence of <0.2%.  

Although many patients are unaware of their infection, because an infection with hepatitis C is often asymptomatic, hepatitis C remains one of the main causes of chronic liver disease worldwide. About 20% of the patients with chronic hepatitis C develop liver-related complications such as liver cirrhosis, after which the risk of liver cancer (hepatocellular carcinoma) is strongly increased. The rate of progression is highly dependent on individual patient characteristics such as age at the time of infection, alcohol use, obesity, and the presence of other co-infections such as HBV en HIV. 

Since the discovery of the hepatitis C virus in 1989, therapy potentials have strongly improved. Until 2010, HCV treatment using (pegylated) interferon and ribavirin was associated with low efficacy and severe side-effects. In recent years HCV treatment has drastically evolved due to the introduction of direct acting antivirals (DAA). New interferon-free, oral treatment regimens are now available with an efficacy as high as 95% and negligible side-effects. The primary endpoint of treatment is viral eradication, defined as a sustained virological response (SVR). This is the situation in which the virus is no longer found in blood 12-24 weeks after discontinuation of treatment. 

The clinical scientific research in our department has a focus on elimination of viral hepatitis in the Netherlands by actively working towards treating all individuals diagnosed with HCV with direct acting antivirals.