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J Gastroenterol Dig Dis 2017 | Volume 2, Issue 3

allied

academies

World Gastroenterological &

Gastroenterology and Endoscopy

October 30-31, 2017 | Toronto, Canada

World Congress on

he development of direct acting antiviral agents (DAA)

for the treatment of HCV provides an opportunity for

eradication. Current DAA agents consist of 2 or 3 inhibitors

of the HCV replication chain and high barriers to resistance.

SVRs are achieved in 97 to 100% of patients treated in trials of

patients with advanced disease and suggest that HCV can be

eliminated. Eradication of in individuals with advanced disease

is unlikely to result in elimination as these individuals are very

ill and unlikely to infect others. If the promise is to be achieved,

physicians, insurers and government agencies must make these

agents available to a much wider group to include those with

thosewithminimal or no liver disease. This latter group includes

individuals with diabetes mellitus, membrano proliferative

glomerulonephritis, thyroiditis, polyarthritis, cryoglobuinemia

and other manifestations of HCV infection. Screening for

hepatitis C is inadequate in these individuals as they are not

aware that they are infected; have no manifestations of liver

disease bringing them to the attention of their physicians and

HCV antibody detection. Individuals with these diseases are

the major source of continued infection and unknowingly

are vectors of the disease. For HCV to be eliminated, current

approaches have to change and mirror those for tuberculosis.

The identification of a positive PPD is sufficient to initiate

therapy. This approach to HCV has been ignored because

the agents previously used were difficult for patients; were

associated with a variety of adverse events; and required

injections and prolonged therapy. Current DAA agents are taken

orally; have minimal side effects and require a treatment for

8-12 weeks. With these changes, a much broader approach to

treatment of HCV is available and can eradicate the disease at

its origin rather than at its end-stage.

Speaker Biography

David H Van Thiel is a Professor of Medicine, a former president of the American

Association for the study of liver disease and is widely recognized as one of the

founding fathers if not, the father of medical liver transplantation worldwide. He

attended Pomona College in Clairemont, California, and then entered Medical School

at the University of California at Los Angeles graduating with honors in 1967. He has

served as the chief of gastroenterology/hepatology at the University of Pittsburgh,

Director of Hepatology at Loyola University Chicago, and Rush University, Chicago. He

is currently in private practice of gastroenterology and hepatology with an emphasis on

hepatology, which accounts for 80%-85% of his practice.

david_vanthiel@

rush.edu

David H Van Thiel

Rush University, USA

Hepatitis C eradication: A unfulfilled promise