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Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2019; 25(29): 3897-3919
Published online Aug 7, 2019. doi: 10.3748/wjg.v25.i29.3897
Consensus on management of hepatitis C virus infection in resource-limited Ukraine and Commonwealth of Independent States regions
Massimo Giuseppe Colombo, Erkin Isakovich Musabaev, Umed Yusupovich Ismailov, Igor A Zaytsev, Alexander V Nersesov, Igor Anatoliyevich Anastasiy, Igor Alexandrovich Karpov, Olga A Golubovska, Kulpash S Kaliaskarova, Ravishankar AC, Sanjay Hadigal
Massimo Giuseppe Colombo, Research and Clinical Center, Department of Medicine, Humanitas Hospital, Rozzano 20089, MI, Italy
Erkin Isakovich Musabaev, Research Institute of Virology, Scientific Research Institute of Virology, Tashkent 100194, Uzbekistan
Umed Yusupovich Ismailov, Hepatoсenter, Research Institute of Virology, Scientific Research Institute of Virology, Tashkent 100194, Uzbekistan
Igor A Zaytsev, Department of Therapy, Infectious Diseases and Dermatology, Bogomolets National Medical University, Kyiv 01601, Ukraine
Alexander V Nersesov, Department of Gastroenterology and Hepatology, National Research Institute of Cardiology and Internal Diseases, Almaty 050000, Kazakhstan
Igor Anatoliyevich Anastasiy, Olga A Golubovska, Department Infectious Diseases, Bogomolets National Medical University, Kyiv 01601, Ukraine
Igor Alexandrovich Karpov, Department Infectious Diseases, Belarus State Medical University, Minsk 220116, Belarus
Kulpash S Kaliaskarova, Hepatology, Ministry of Health, Astana 010000, Kazakhstan
Ravishankar AC, Sanjay Hadigal, Medical Affairs, Mylan Pharmaceuticals Private Limited, Kadubeesanahalli, Bengaluru 560103, India
Author contributions: All authors contributed equally to this paper with the conception and design of the study, literature review and analysis, and drafting, critical revision and editing of the manuscript, and provided approval of the final version.
Conflict-of-interest statement: Colombo MG received grants/research/clinical trial support from Bristol-Meyers Squibb [Hepatology, viral hepatitis C (Daclatasvir)], Gilead Sciences [Hepatology, viral hepatitis C (Sofosbuvir)], and Merck [Hepatology, viral hepatitis C (Boceprevir)]. Colombo MG is a part of the speaker’s bureau at Bayer, Gilead Sciences, and Roche and is a consultant and advisory panel at Bayer, AbbVie, Gilead Sciences, Janssen, Merck, Roche, Mylan, and Boehringer Ingelheim. Nersesov AV supports research at Janssen, Merck, AbbVie, Abbott, and Sanofi. Nersesov AV is a part of the speaker’s bureau at Abbott, AbbVie, Bayer, Gilead Sciences, Janssen, Merck, Roche, and Sanofi and is a board member/advisory panel at Abbott, AbbVie, Gilead Sciences, Janssen, Merck, Roche, and Mylan. Ravishankar AC and Hadigal S are employees at Mylan Pharmaceuticals Private Limited. The remaining authors have no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Massimo Giuseppe Colombo, MD, Director, Research and Clinical Center, Department of Medicine, Humanitas Hospital, Via Alessandro Manzoni 56, Rozzano 20089, MI, Italy. massimo.colombo@humanitas.it
Telephone: +39-335-5719512
Received: March 23, 2019
Peer-review started: March 25, 2019
First decision: April 11, 2019
Revised: June 4, 2019
Accepted: June 8, 2019
Article in press: June 6, 2019
Published online: August 7, 2019
Abstract

Globally, 69.6 million individuals were infected with hepatitis C virus (HCV) infection in 2016. Of the six major HCV genotypes (GT), the most predominant one is GT1, worldwide. The prevalence of HCV in Central Asia, which includes most of the Commonwealth of Independent States (CIS), has been estimated to be 5.8% of the total global burden. The predominant genotype in the CIS and Ukraine regions has been reported to be GT1, followed by GT3. Inadequate HCV epidemiological data, multiple socio-economic barriers, and the lack of region-specific guidelines have impeded the optimal management of HCV infection in this region. In this regard, a panel of regional experts in the field of hepatology convened to discuss and provide recommendations on the diagnosis, treatment, and pre-, on-, and posttreatment assessment of chronic HCV infection and to ensure the optimal use of cost-effective antiviral regimens in the region. A comprehensive evaluation of the literature along with expert recommendations for the management of GT1-GT6 HCV infection with the antiviral agents available in the region has been provided in this review. This consensus document will help guide clinical decision-making during the management of HCV infection, further optimizing treatment outcomes in these regions.

Keywords: Antiviral agents, Commonwealth of Independent States, Genotype, Hepatitis C virus, Sustained virologic response, Ukraine

Core tip: A high prevalence of hepatitis C virus (HCV) infection has been reported in Ukraine and most of the Commonwealth of Independent States regions. The scarcity of adequate epidemiological data, the lack of national guidelines, and multiple socio-economic barriers hinder the effective management of HCV infection in these regions. The current consensus document intends to guide clinicians and healthcare providers on the diagnosis, treatment, and pre-, on-, and posttreatment assessment of HCV infection and to help optimize the treatment outcomes in the region.