Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2018; 10(10): 639-644
Published online Oct 27, 2018. doi: 10.4254/wjh.v10.i10.639
European Association for the Study of the Liver and French hepatitis C recent guidelines: The paradigm shift
Véronique Loustaud-Ratti, Marilyne Debette-Gratien, Paul Carrier
Véronique Loustaud-Ratti, Marilyne Debette-Gratien, Paul Carrier, Fédération d'Hépatologie, Service d’Hépato-gastroentérologie, CHU Limoges, Limoges 87042, France
Author contributions: Loustaud-Ratti V and Carrier P wrote the manuscript; Debette-Gratien M reread the manuscript and brought her expertise.
Conflict-of-interest statement: Dr. Loustaud-Ratti reports personal fees from GILEAD, personal fees from MSD, personal fees from ABBVIE, grants and personal fees from BMS, outside the submitted work.
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/
Correspondence to: Véronique Loustaud-Ratti, MD, Professor, Fédération d'Hépatologie, Service d’Hépato-gastroentérologie, CHU Limoges, 2, Avenue Martin Luther King, Limoges 87042, France. veronique.loustaud-ratti@unilim.fr
Telephone: +33-5-55056684
Received: June 21, 2018
Peer-review started: June 21, 2018
First decision: July 9, 2018
Revised: July 17, 2018
Accepted: August 4, 2018
Article in press: August 4, 2018
Published online: October 27, 2018
Processing time: 128 Days and 14.5 Hours
Abstract

The latest Association Française pour l’Etude du Foie - French Association for Study of the Liver (AFEF) and European Association for the Study of the Liver (EASL) recommendations announce a change of paradigm, for the management of patients infected with hepatitis C virus (HCV). The AFEF recommendations focus on the elimination of HCV infection on a national level by preventing reinfection, in less than ten years. This goal involves the facilitation of patients’ management in a simplified pathway by increasing screening procedures and access to pangenotypic treatments mainly in the “reservoir” population of people who inject drugs and migrants. Even in the complex pathway of patients with previous comorbidities, AFEF takes the option of a therapeutic simplification. The EASL guidelines position themselves on the state of the art with a precise description of all therapeutic options available, without separating simplified and complex pathways even if they take into account the epidemiological evolution of difficult-to-treat populations.

Keywords: French; European; Hepatitis C; Guidelines; Pangenotypic; Direct acting antiviral drugs; Eradication; People who inject drugs; Migrants

Core tip: New French and European guidelines for the management of hepatitis C virus infection take into account the rapid change in the epidemiology of the infection and the arrival of short treatments, based on pangenotypic drugs with very few side effects. However, the French guidelines have a strong bias towards viral eradication with the elaboration of a simplified pathway for patients who are far from traditional healthcare structures.