Download the free PDF of this book from www.HepatologyTextbook.com Download Free PDF Download Free PDF the Fling Publisher the Fling Publisher Short Guide to Hepatitis C / Short Guide to edited b Mauss et al. Mauss, Berg, Rockstroh, Sarrazin, Wedemeyer Hepatitis C edited b Mauss, Berg, Rockstroh, Sarrazin, Wedemeyer Exciting new treatment approaches make the management of hepatitic C one of the most rapidly developing areas of medicine. e Flying Publisher hort Guide to Hepatitis C is an up-to-date source of information for physicians, residents and advanced medical students. www.yingpublisher.com Short Guide to Hepatitis C ISBN 978-3-942687-15-7 F P F F P 9 783942 687157 > Mauss − Berg − Rockstroh − Sarrazin − Wedemeyer Short Guide to Hepatitis C 2014 Edition This PDF of the 2014 Flying Publisher Short Guide to Hepatitis C is freely available from www.FlyingPublisher.com thanks to the financial support provided by Stefan Mauss Thomas Berg Jürgen Rockstroh Christoph Sarrazin Heiner Wedemeyer The Flying Publisher Short Guide to Hepatitis C 2014 Edition Flying Publisher 4 | Copy Editor: Rob Camp [email protected] Disclaimer Hepatitis C management is an ever-changing field. The publishers and author of The Flying Publisher Short Guide to Hepatitis C have made every effort to provide information that is accurate and complete as of the date of publication. However, in view of the rapid changes occurring in hepatitis C management, as well as the possibility of human error, this guide may contain technical inaccuracies, typographical or other errors. It is the responsibility of the physician to rely on experience and knowledge about the patient to determine the most adequate treatment. The information contained herein is provided “as is” and without warranty of any kind. The contributors to this book, including Flying Publisher & Kamps, can not be held responsible for any errors or omissions or for results obtained from the use of information contained herein. This work is protected by copyright both as a whole and in part. © 2014 by Flying Publisher & Kamps Design: Attilio Baghino, www.baghino.com ISBN: 978-3-942687-15-7 Printed in Germany by Druckhaus Süd, www.druckhaus-sued.de | 5 Preface Hepatitis C is a rapidly developing area of medicine – diagnostic tools are ever more refined, and entirely new treatments and treatment strategies are arriving, with more on the horizon. And because the virus affects such a large and varying population – up to 170 million at last count – we think it is important to have a pocket reference especially devoted to hepatitis C. We look forward to your comments on the usefulness of our 2014 Short Guide to Hepatitis C, which is an expansion and update of the HCV chapters in Hepatology – A Clinical Textbook (2014), also published by Flying Publisher. As always, we invite qualified people everywhere to translate this book into other languages, and make them available widely. This web-based free-of-charge concept is made possible by unrestricted educational grants from the pharmaceutical industry and has allowed the material to reach countries usually not covered by print media. We are convinced that this new pocket guide concept, focusing here on hepatitis C, will become a valuable source of information for our readers. Stefan Mauss Thomas Berg Jürgen Rockstroh Christoph Sarrazin Heiner Wedemeyer The Editors January 2014 6 | The 2014 Short Guide to Hepatitis C Contributing Authors Thomas Berg Katja Deterding Sektion Hepatologie Dept. of Gastroenterology, Klinik und Poliklinik für Hepatology and Endocrinology Gastroenterologie & Medical School of Hannover Rheumatologie Carl-Neuberg-Str. 1 Universitätsklinikum Leipzig 30625 Hannover, Germany Liebigstr. 20 04103 Leipzig, Germany Svenja Hardtke Leber- und Studienzentrum am Dept. of Gastroenterology, Checkpoint Hepatology and Endocrinology Charlottenstrasse 81 Medical School of Hannover 10969 Berlin Carl-Neuberg-Str. 1 30625 Hannover, Germany Christoph Boesecke Department of Medicine I Christoph Höner zu University Hospital Bonn Siederdissen Sigmund-Freud-Strasse 25 Dept. of Gastroenterology, 53105 Bonn, Germany Hepatology and Endocrinology Medical School of Hannover Albrecht Böhlig Carl-Neuberg-Str. 1 Sektion Hepatologie 30625 Hannover, Germany Klinik und Poliklinik für Bernd Kupfer Gastroenterologie & Bonn University Hospital Rheumatologie Department of Medicine I Universitätsklinikum Leipzig Sigmund-Freud-Strasse 25 Liebigstr. 20 53015 Bonn, Germany 04103 Leipzig, Germany Christian Lange Markus Cornberg J. W. Goethe University Dept. of Gastroenterology, Hospital Hepatology Medical Department I and Endocrinology Theodor-Stern-Kai 7 Medical School of Hannover 60590 Frankfurt/Main, Carl-Neuberg-Str. 1 Germany 30625 Hannover, Germany | 7 Michael P. Manns J. K. Rockstroh Dept. of Gastroenterology, Department of Medicine I Hepatology University Hospital Bonn and Endocrinology Sigmund-Freud-Strasse 25 Medical School of Hannover 53105 Bonn, Germany Carl-Neuberg-Str. 1 Christoph Sarrazin 30625 Hannover, Germany J. W. Goethe University Hospital Benjamin Maasoumy Medical Department I Dept. of Gastroenterology, Theodor-Stern-Kai 7 Hepatology and Endocrinology 60590 Frankfurt/Main, Medical School of Hannover Germany Carl-Neuberg-Str. 1 30625 Hannover, Germany Martin Schäfer Department of Psychiatry Stefan Mauss and Psychotherapy Center for HIV and Kliniken Essen-Mitte Hepatogastroenterology Ev. Huyssenstift Grafenberger Allee 128a Henricistraße 92 40237 Duesseldorf, Germany 45136 Essen, Germany Kerstin Port Carolynne Schwarze-Zander Dept. of Gastroenterology, Department of Medicine I Hepatology and Endocrinology University Hospital Bonn Medical School of Hannover Sigmund-Freud-Strasse 25 Carl-Neuberg-Str. 1 53105 Bonn, Germany 30625 Hannover, Germany Jan-Christian Wasmuth Karl-Philipp Puchner Department of Medicine I Charité, Campus Virchow- University Hospital Bonn Klinikum, Sigmund-Freud-Strasse 25 Universitätsmedizin 53105 Bonn, Germany Medizinische Klinik m. S. Hepatologie und Heiner Wedemeyer Gastroenterologie Dept. of Gastroenterology, Augustenburger Platz 1 Hepatology 13353 Berlin, Germany and Endocrinology Medical School of Hannover Carl-Neuberg-Str. 1 30625 Hannover, Germany 8 | The 2014 Short Guide to Hepatitis C | 9 Abbreviations ADV: adefovir dipivoxil NHL: non-Hodgkin lymphoma AHA: autoimmune haemolytic NPV: negative predictive value anaemia NTR: non-translated regions ALT: alanine aminotransferase PCR: polymerase chain AST: aspartate reaction aminotransferase PCT: porphyria cutanea tarda BID: twice a day PEG-IFN: pegylated interferon BOC: boceprevir PT: prothrombin time cccDNA: covalently closed QD: once a day circular DNA QW: once a week CP: Child-Pugh RF: rheumatoid factor EHM: extrahepatic RVR: rapid virologic response manifestation SSRI: selective serotonin ER: endoplasmic reticulum reuptake inhibitor EVR: early virologic response SVR: sustained virologic GH: growth hormone response GM-CSF: granulocyte TGF: transforming growth macrophage factor colony-stimulating factor RBV: ribavirin GN: glomerulonephritis TID: three times a day HBsAg: hepatitis B surface TLP: telaprevir antigen TSH: thyroid stimulating HBV: hepatitis B virus hormone HCV: hepatitis C virus HCV RNA: riboneucleic acid of hepatitis C virus HCC: hepatocellular carcinoma IFN alfa: interferon alfa IGF-1: insulin growth factor-1 INR: international normalised ratio IPF: idiopathic pulmonary fibrosis ITP: immune thrombocytopenic purpura LDL: low density lipoproteins MELD: Model for End-Stage Liver Disease 10 | The 2014 Short Guide to Hepatitis C | 11 Table of Contents 1. Epidemiology, Transmission and Natural History .................. 17 Christoph Boesecke and Jan-Christian Wasmuth ....................... 17 Epidemiology ........................................................................... 17 Transmission............................................................................ 18 Acute hepatitis......................................................................... 19 Chronic hepatitis ..................................................................... 19 Natural history.................................................................... 20 Cirrhosis and hepatic decompensation ........................... 20 Disease progression ............................................................ 20 2. HCV Structure and Viral Replication ....................................... 23 Bernd Kupfer .............................................................................. 23 Taxonomy and genotypes ...................................................... 23 Viral structure ......................................................................... 23 Genome organization ......................................................... 24 HCV proteins ....................................................................... 25 Viral lifecycle ........................................................................... 26 Adsorption and viral entry ................................................ 26 Translation and post-translational processes ................ 27 HCV RNA replication .......................................................... 28 Assembly and release ......................................................... 28 Model systems for research .............................................. 29 3. Diagnostic Tests in Acute and Chronic Hepatitis C ................ 30 Christian Lange and Christoph Sarrazin .................................... 30 Serologic assays ......................................................................