par Moreno, Christophe ;Domngang, Doris
Référence Revue médicale de Bruxelles, 37, 4, page (283-288)
Publication Publié, 2016-09
Article révisé par les pairs
Résumé : Chronic hepatitis C virus infection is a major public health problem. It is estimated that 15 to 35 % of infected patients will develop cirrhosis after a period of 30 years. Fibrosis stage must be evaluated in all hepatitis-C-infected patients, even in patients with normal serum transaminases. Non-invasive methods for the evaluation of liver fibrosis have been developed, mainly serum markers and transient elastography or Fibroscan™. The goal of therapy is to achieve a sustained virological response, defined by hepatitis C RNA undetectable in serum 12 weeks after the end of therapy. This indicates viral eradication. Treatment of chronic hepatitis C is a real revolution. New therapies consist in direct acting antivirals. These treatments offer high chance of viral eradication (> 90 %), and are very well tolerated. In Belgium, at the moment, reimbursement of new antiviral therapies is limited to patients with advanced fibrosis or cirrhosis. Those reimbursement criteria would change in a very near future, allowing more patients to be treated. Hepatitis C viral elimination is possible in the next 15 years at a population level in Belgium, but this implies a significant improvement in screening and access to therapy.