Asymptomatic chronic hepatitis C with F0-1 fibrosis: Treat now

Abstract

Patients with chronic hepatitis C with no or minimal liver fibrosis (F0-F1 Fibrosis) were 50% of the entire group of patients with chronic hepatitis C. Although this group of patients might have to defer treatment due to treatment prioritization strategy, as the excellent performance of regimens with few side-effects, if in the future they would have access the treatment, the number of patient with chronic hepatitis C would decrease dramatically. After following up with treatment-naive patients for five years, 60% of them had the fibrosis progression. Patients with minimal fibrosis had possibility of advanced fibrosis at 30%. Findings indicated that the infection in the old aged patient, infection for long period, chronic hepatic inflammation, steatosis, insulin resistance and alcohol drinking affected the rapid fibrosis progression. Having treatment from F0-F1 stage was count for the long-term benefit as it reduced the development of advanced fibrosis for 15% and the survival rate at 15 years better than the non - treatment group, since it minimized the chance of cirrhosis and the extrahepatic mortality.After viral eradication, it would minimize health service and following up expenses on chronic patients.Symptom conditions such as fatique, impaired cognitive function, obsessive-compulsive, depression,and anxiety were improved that affected the better quality of life. The expenses and longer quality-adjustlife year of the treatment from minimal or no fibrotic stage should be taken into account comparingwith the treatment from significant fibrotic stage according to the health economic evaluation.Early treatment in patients with minimal or no fibrotic stage who had factors affecting the rapidfibrosis progression would result in cost-effectiveness.
 
 Keywords: chronic hepatitis C, fibrosis progression, cost-effectiveness, quality-adjust life years, increment cost effectiveness ratio