Identifying Gaps in the Treatment Guidelines for Hepatitis C in Peru to Meet International Standards: A Narrative Review
Author(s)
Jose Armando Gonzales Zamora
Carlos Quispe‐Vicuña
Martín E. Reategui-Garcia
Julieta M. Araoz-Salinas
Fabricio Ccami‐Bernal
Noelia Morocho-Alburqueque
Jian Pierre Espinoza-Herreros
Josue Layme
Gabriel Aquino-Sandoval
Víctor Yosef Melt Campos
Date Issued
30 de junio de 2024
Type
Other
Volume
13
Issue
13
Start Page
3867
End Page
3867
Abstract
Hepatitis C virus still represents a major cause of morbidity and mortality worldwide. In Peru, two national practice guidelines for the management of this infection were published more than 5 years ago; however, the latest breakthroughs in the treatment make it necessary to update these guidelines. We reviewed the most recent recommendations of the international guidelines and compared them with the current Peruvian guidelines. We found major differences, such as the use of Glecaprevir/Pibrentasvir as a first-line therapy, which is contemplated in the World Health Organization guideline, and recommended by American and European guidelines, but is not considered in the Peruvian guidelines. Another crucial difference lies in the management of patients with chronic kidney disease, who are treated nowadays with a variety of direct-acting antivirals, with no restrictions on the use of Sofosbuvir-based regimens in first-world countries, an approach that has not been adopted in Peru. We believe that standardization of the recommendations of the Peruvian guidelines is imperative, including the new therapeutic strategies that have emerged in recent years. We also suggest conducting a cost effectiveness analysis in the Peruvian context to allow for the implementation of new antivirals, and to achieve a better control of hepatitis C in the country.
Subjects