{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T15:20:47Z","timestamp":1651332047871},"reference-count":69,"publisher":"Akademiai Kiado Zrt.","issue":"Supplement 1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orvosi Hetilap"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>Approximately 70,000 people are infected with hepatitis C virus in Hungary, and more than half of them are not aware of their infection. From the point of infected individuals early recognition and effective treatment of related liver injury may prevent consequent advanced liver diseases and complications (liver cirrhosis, liver failure and liver cancer) and can increase work productivity and life expectancy. From a socioeconomic aspect, this could also prevent further spread of the virus as well as reduce substantially long term financial burden of related morbidity. Pegylated interferon + ribavirin dual therapy, which is available in Hungary since 2003, can clear the virus in 40\u201345% of previously not treated (na\u00efve), and in 5\u201321% of previous treatment-failure patients. Addition of a direct acting first generation protease inhibitor drug (boceprevir or telaprevir) to the dual therapy increases the chance of sustained viral response to 63\u201375% and 59\u201366%, respectively. These two protease inhibitors are available and financed for a segment of Hungarian patients since May 2013. Between 2013 and February 2015, other direct acting antiviral interferon-free combination therapies have been registered for the treatment of chronic hepatitis C, with a potential efficacy over 90% and typical short duration of 8\u201312 weeks. Indication of therapy includes exclusion of contraindications to the drugs and demonstration of viral replication with consequent liver injury, i.e., inflammation and \/ or fibrosis in the liver. Non-invasive methods (elastography and biochemical methods) are accepted and preferred for staging liver damage (fibrosis). For initiation of treatment as well as for on-treatment decisions, accurate and timely molecular biology tests are mandatory. Eligibility for treatment is a subject of individual central medical review. Due to budget limitations therapy is covered only for a proportion of patients by the National Health Insurance Fund. Priority is given to those with urgent need based on a Hungarian Priority Index system reflecting primarily the stage of liver disease, and considering also additional factors, i.e., activity and progression of liver disease, predictive factors of treatment and other special issues. Approved treatments are restricted to the most cost-effective combinations based on the cost per sustained viral response value in different patient categories with consensus between professional organizations, National Health Insurance Fund and patient organizations. More expensive therapies might be available upon co-financing by the patient or a third party. Interferon-free treatments and shorter therapy durations preferred as much as financially feasible. A separate budget is allocated to cover interferon-free treatments for the most-in-need interferon ineligible\/intolerant patients, and for those who have no more interferon-based therapy option. Orv. Hetil., 2015, 156(Suppl. 1), 3\u201323.<\/jats:p>","DOI":"10.1556\/oh.2015.30107","type":"journal-article","created":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T02:09:52Z","timestamp":1424743792000},"page":"3-23","source":"Crossref","is-referenced-by-count":1,"title":["Diagnosis, treatment, and follow-up of hepatitis C virus related liver disease.<i>Hungarian national consensus guideline<\/i>"],"prefix":"10.1556","volume":"156","author":[{"given":"B\u00e9la","family":"Hunyady","sequence":"first","affiliation":[{"name":"Somogy Megyei Kaposi M\u00f3r Oktat\u00f3 K\u00f3rh\u00e1z Belgy\u00f3gy\u00e1szati Oszt\u00e1ly Kaposv\u00e1r Talli\u00e1n Gy. u. 20\u201332. 7400"},{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. Belgy\u00f3gy\u00e1szati Klinika P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"Gerlei","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Transzplant\u00e1ci\u00f3s \u00e9s Seb\u00e9szeti Klinika Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judit","family":"Gervain","sequence":"additional","affiliation":[{"name":"Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z I. Belgy\u00f3gy\u00e1szat \u00e9s Molekul\u00e1ris Diagnosztikai Laborat\u00f3rium Sz\u00e9kesfeh\u00e9rv\u00e1r"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"Szent J\u00e1nos K\u00f3rh\u00e1z \u00e9s \u00c9szak-budai Egyes\u00edtett K\u00f3rh\u00e1zak Hepatol\u00f3giai Szakrendel\u00e9s Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Lengyel","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar II. Belgy\u00f3gy\u00e1szati Klinika Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alajos","family":"P\u00e1r","sequence":"additional","affiliation":[{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. Belgy\u00f3gy\u00e1szati Klinika P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"R\u00f3kusz","sequence":"additional","affiliation":[{"name":"MH Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont Honv\u00e9dk\u00f3rh\u00e1z I. Belgy\u00f3gy\u00e1szati Oszt\u00e1ly Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Szalay","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. Belgy\u00f3gy\u00e1szati Klinika Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"\u2020Telegdy","sequence":"additional","affiliation":[{"name":"Egyes\u00edtett Szent Istv\u00e1n \u00e9s Szent L\u00e1szl\u00f3 K\u00f3rh\u00e1z Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Istv\u00e1n","family":"Tornai","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Orvos- \u00e9s Eg\u00e9szs\u00e9gtudom\u00e1nyi Centrum Belgy\u00f3gy\u00e1szati Int\u00e9zet Debrecen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kl\u00e1ra","family":"Werling","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar II. 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[A magyarorsz\u00e1gi kr\u00f3nikus \u201cC\u201d v\u00edrushepatitises betegek v\u00edrust\u00edpus- \u00e9s szubt\u00edpus-meghat\u00e1roz\u00e1sa.] Orv. Hetil., 2001, <i>142<\/i>(25), 1315\u20131319. [Hungarian]"},{"key":"3","doi-asserted-by":"crossref","unstructured":"<i>Van der Meer, A. J., Veldt, B. J., Feld, J. J., et al.:<\/i> Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA, 2012, <i>308<\/i>(24), 2584\u20132593.","DOI":"10.1001\/jama.2012.144878"},{"key":"4","unstructured":"<i>Makara, M., Horv\u00e1th, G., Szalay, F., et al.:<\/i> Organizational characteristics of treatment for chronic hepatitis in Hungary: Hepatitis Registry and Priority Index. [A kr\u00f3nikus v\u00edrushepatitisek hazai ell\u00e1t\u00e1si rendszer\u00e9nek saj\u00e1toss\u00e1gai: Hepatitis Regiszter \u00e9s a Priorit\u00e1si Index.] Orv. Hetil., 2013, <i>154<\/i>(29), 1151\u20131155. 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Press release. 07\/07\/2014. news.bms.com\/press-release\/japan-approves-first-all-oral-interferon-and-ribavirin-free-hepatitis-c-treatment-dakl"},{"key":"14","unstructured":"<i>European Medicines Agency:<\/i> Applications for new human medicines under evaluation by the Committee for Medicinal Products for Human Use. Ombitasvir\/paritaprevir\/ritonavir. 04\/07\/ 2014. <a href=\"http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Report\/2014\/07\/WC500169655.pdf\">http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Report\/2014\/07\/WC500169655.pdf<\/a>"},{"key":"15","doi-asserted-by":"crossref","unstructured":"<i>European Association for the Study of the Liver:<\/i> EASL Clinical Practice Guidelines: Management of hepatitis C virus infection. J. Hepatol., 2014, <i>60<\/i>(2), 392\u2013420.","DOI":"10.1016\/j.jhep.2013.11.003"},{"key":"16","unstructured":"<i>The American Association for the Study of Liver Diseases:<\/i> AASLD-IDSA Recommendations for testing, managing, and treating hepatitis C. 21\/03\/2014. <a href=\"http:\/\/www.hcvguidelines.org\/fullreport\">http:\/\/www.hcvguidelines.org\/fullreport<\/a>"},{"key":"17","unstructured":"<i>World Health Organization:<\/i> Guidelines for the screening, care and treatment of persons with hepatitis C infection. 19\/04\/2014. <a href=\"http:\/\/www.who.int\/hiv\/pub\/hepatitis\/hepatitis-c-guidelines\/en\/\">http:\/\/www.who.int\/hiv\/pub\/hepatitis\/hepatitis-c-guidelines\/en\/<\/a>"},{"key":"18","doi-asserted-by":"crossref","unstructured":"<i>Hunyady, B., Gervain, J., Horv\u00e1th G., et al.:<\/i> Diagnosis, treatment, and follow-up of hepatitis C-virus related liver disease. Hungarian national consensus guideline. 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[Hungarian]"},{"key":"20","doi-asserted-by":"crossref","unstructured":"<i>Lin, O. S., Keeffe, E. B., Sanders, G. D., et al.:<\/i> Cost-effectiveness of screening for hepatocellular carcinoma in patients with cirrhosis due to chronic hepatitis C. Aliment. Pharmacol. Ther., 2004, <i>19<\/i>(11), 1159\u20131172.","DOI":"10.1111\/j.1365-2036.2004.01963.x"},{"key":"21","doi-asserted-by":"crossref","unstructured":"<i>European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer:<\/i> ASL\u2013EORTC clinical practice guidelines: Management of hepatocellular carcinoma. J. Hepatol., 2012, <i>56<\/i>(4), 908\u2013943.","DOI":"10.1016\/j.jhep.2011.12.001"},{"key":"22","doi-asserted-by":"crossref","unstructured":"<i>Poordad, F., Lawitz, E., Reddy, K. R., et al.:<\/i> Effects of ribavirin dose reduction vs erythropoietin for boceprevir-related anemia in patients with chronic hepatitis C virus genotype 1 infection \u2013 a randomized trial. 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