Treatment Target: Would prioritizing treatment be necessary in DAA era? = Treatment Target: Would prioritizing treatment be necessary in DAA era?

다국어 초록 (Multilingual Abstract)

Treatment decision guided by the liver fibrosis or state of liver disease has been recommended to target only those who could potentially benefit the most as well as to minimize the side effects. One of important reasons for staging guided treatment recommendation was related to the relatively low efficacy of interferon-based therapy and/or frequent intolerable adverse events associated treatment regimen. In the era of interferon-free direct antiviral agents for hepatitis C virus (HCV) with higher efficacy and better side effect profile, the value of staging guided treatment becomes questionable. Recently, real practice data regarding excellent sustained virological response rate of interferon-free direct acting antiviral agents with better safety profile was accumulated. Therefore, all hepatitis C patients can be considered for antiviral treatment except who have short life expectancies that cannot be modulated by anti-HCV therapy, by liver transplantation, or by other special treatment. Accordingly, guidance for prioritizing treatment first to those with the greatest need is now less useful and have been removed from the Western anti-HCV treatment practice guidance. However, since the epidemiologic characteristics and healthcare systems differ among nations, further research on cost effectiveness could be needed to determine the optimal treatment strategy for Korea.