{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T16:43:30Z","timestamp":1698252210895},"reference-count":0,"publisher":"Akademiai Kiado Zrt.","issue":"Supplement 2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orvosi Hetilap"],"published-print":{"date-parts":[[2015,12,15]]},"abstract":"<jats:p> Approximately 70.000 people are infected with hepatitis C virus in Hungary, more than half of whom 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 on one hand. From socioeconomic aspect, this could also prevent further spread of the virus as well as reduce substantially long term financial burden of related morbidity. Available since 2003 in Hungary, pegylated interferon + ribavirin dual therapy 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 virologic 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 (eleastography and biochemical methods) are accepted and preferred for staging liver damage (fibrosis). For initiation of treatment accurate and timely molecular biology tests are mandatory. Eligibility for treatment is a subject of individual central medical review. Due to budget limitations tharpy 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 virologic 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. 2), 3\u201324. <\/jats:p>","DOI":"10.1556\/oh.2015.30345","type":"journal-article","created":{"date-parts":[[2015,12,15]],"date-time":"2015-12-15T08:19:42Z","timestamp":1450167582000},"page":"3-24","source":"Crossref","is-referenced-by-count":1,"title":["Hepatitis C-v\u00edrus-fert\u0151z\u00e9s: diagnosztika, antivir\u00e1lis                     ter\u00e1pia, kezel\u00e9s ut\u00e1ni gondoz\u00e1s. <i>Magyar konszenzusaj\u00e1nl\u00e1s. \u00c9rv\u00e9nyes:                         2015. szeptember 12-t\u0151l<\/i>"],"prefix":"10.1556","volume":"156","author":[{"given":"B\u00e9la","family":"Hunyady","sequence":"first","affiliation":[{"name":"Gasztroenterol\u00f3gia Oszt\u00e1ly, Somogy Megyei Kaposi M\u00f3r Oktat\u00f3 K\u00f3rh\u00e1z Kaposv\u00e1r, Talli\u00e1n Gy. u. 20\u201332., 7400"},{"name":"I. Belgy\u00f3gy\u00e1szati Klinika, P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"Gerlei","sequence":"additional","affiliation":[{"name":"Transzplant\u00e1ci\u00f3s \u00e9s Seb\u00e9szeti Klinika,                         Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judit","family":"Gervain","sequence":"additional","affiliation":[{"name":"Belgy\u00f3gy\u00e1szat \u00e9s Molekul\u00e1ris Diagnosztikai Laborat\u00f3rium,                         Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z Sz\u00e9kesfeh\u00e9rv\u00e1r"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Horv\u00e1th","sequence":"additional","affiliation":[{"name":"Hepatol\u00f3giai Szakrendel\u00e9s, Budapest \u00e9s Budai                     Hepatol\u00f3giai Centrum, Szent J\u00e1nos K\u00f3rh\u00e1z \u00e9s \u00c9szak-budai Egyes\u00edtett K\u00f3rh\u00e1zak Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Lengyel","sequence":"additional","affiliation":[{"name":"II. Belgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alajos","family":"P\u00e1r","sequence":"additional","affiliation":[{"name":"I. Belgy\u00f3gy\u00e1szati Klinika, P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar P\u00e9cs"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"P\u00e9ter","sequence":"additional","affiliation":[{"name":"II. Belgy\u00f3gy\u00e1szati Klinika, Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"R\u00f3kusz","sequence":"additional","affiliation":[{"name":"I. Belgy\u00f3gy\u00e1szati Oszt\u00e1ly, MH Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont Honv\u00e9dk\u00f3rh\u00e1z Budapest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Schneider","sequence":"additional","affiliation":[{"name":"Infektol\u00f3gia Oszt\u00e1ly, Markusovszky Egyetemi Oktat\u00f3k\u00f3rh\u00e1z Szombathely"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Szalay","sequence":"additional","affiliation":[{"name":"I. 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