Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain.
International Association of Providers of AIDS Care, Washington, DC, USA.
Liver Unit, Rush University Medical Center, Chicago, IL, USA.
The International Conference on Viral Hepatitis 2017 brought exciting news on the treatment of viral hepatitis. The most recent estimates of the burden for hepatitis B virus and hepatitis C virus (HCV) infections were presented. The current gaps and prospects for regional and global eradication of viral hepatitis were discussed on the light of the WHO roadmap until 2030. Debates focused on hepatitis C and expectations using the new approved HCV pan-genotypic, once daily, oral direct-acting antivirals (DAAs), glecaprevir-pibrentasvir, and sofosbuvir-velpatasvir-voxilaprevir. The management of difficult-to-cure HCV patients included individuals who had failed prior DAAs, people who inject drugs, patients with decompensated cirrhosis, or renal insufficiency. Special patient populations such as children, pregnant women, persons with acute hepatitis C, or HIV coinfection were addressed separately. The use of HCV treatment as prevention was subject to debate, balancing the benefits on halting transmission and the risk for HCV reinfections and high medication costs. Complementary efforts on behavioral interventions and harm reduction programs were highlighted. Data from both clinical trials and real-world experience (i.e., from the US Veterans) were compared. Further debates addressed hepatic conditions that may alter the management and outcome of viral hepatitis, such as hepatitis B reactivation, non-alcoholic fatty liver disease, liver transplantation, and hepatocellular carcinoma. Finally, the recent data on often neglected hepatitis D and E virus infections were reviewed.