Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline
Identifieur interne : 002D91 ( Pmc/Curation ); précédent : 002D90; suivant : 002D92Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline
Auteurs : Seyed Moayed Alavian ; Behzad Hajarizadeh [Australie] ; Kamran Bagheri Lankarani ; Heidar Sharafi ; Nasser Ebrahimi Daryani ; Shahin Merat ; Minoo Mohraz ; Masoud Mardani ; Mohamad Reza Fattahi ; Hossein Poustchi ; Mehri Nikbin ; Mahmood Nabavi ; Peyman Adibi ; Masood Ziaee ; Bita Behnava ; Mohammad Saeid Rezaee-Zavareh ; Massimo Colombo [Italie] ; Hatef Massoumi [États-Unis] ; Abdul Rahman Bizri [Liban] ; Bijan Eghtesad [États-Unis] ; Majid Amiri [France] ; Ali Namvar ; Khashayar Hesamizadeh ; Reza MalekzadehSource :
- Hepatitis Monthly [ 1735-143X ] ; 2016.
Abstract
Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran.
The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3rd national consensus on management of Hepatitis C in Iran, held on 22nd of July 2016.
Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered.
Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection.
Url:
DOI: 10.5812/hepatmon.guideline
PubMed: 27799966
PubMed Central: 5075356
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Seyed Moayed Alavian<affiliation><nlm:aff id="aff101799">Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="aff101800">Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff101800">Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff101803">Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
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<affiliation><nlm:aff id="aff101822">Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran</nlm:aff>
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<affiliation><nlm:aff id="aff101808">Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran</nlm:aff>
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<affiliation><nlm:aff id="aff101809">Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, IR Iran</nlm:aff>
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<author><name sortKey="Mohraz, Minoo" sort="Mohraz, Minoo" uniqKey="Mohraz M" first="Minoo" last="Mohraz">Minoo Mohraz</name>
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<author><name sortKey="Fattahi, Mohamad Reza" sort="Fattahi, Mohamad Reza" uniqKey="Fattahi M" first="Mohamad Reza" last="Fattahi">Mohamad Reza Fattahi</name>
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<author><name sortKey="Nabavi, Mahmood" sort="Nabavi, Mahmood" uniqKey="Nabavi M" first="Mahmood" last="Nabavi">Mahmood Nabavi</name>
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<author><name sortKey="Adibi, Peyman" sort="Adibi, Peyman" uniqKey="Adibi P" first="Peyman" last="Adibi">Peyman Adibi</name>
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<author><name sortKey="Ziaee, Masood" sort="Ziaee, Masood" uniqKey="Ziaee M" first="Masood" last="Ziaee">Masood Ziaee</name>
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<author><name sortKey="Malekzadeh, Reza" sort="Malekzadeh, Reza" uniqKey="Malekzadeh R" first="Reza" last="Malekzadeh">Reza Malekzadeh</name>
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<author><name sortKey="Alavian, Seyed Moayed" sort="Alavian, Seyed Moayed" uniqKey="Alavian S" first="Seyed Moayed" last="Alavian">Seyed Moayed Alavian</name>
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<author><name sortKey="Hajarizadeh, Behzad" sort="Hajarizadeh, Behzad" uniqKey="Hajarizadeh B" first="Behzad" last="Hajarizadeh">Behzad Hajarizadeh</name>
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<author><name sortKey="Bagheri Lankarani, Kamran" sort="Bagheri Lankarani, Kamran" uniqKey="Bagheri Lankarani K" first="Kamran" last="Bagheri Lankarani">Kamran Bagheri Lankarani</name>
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<author><name sortKey="Sharafi, Heidar" sort="Sharafi, Heidar" uniqKey="Sharafi H" first="Heidar" last="Sharafi">Heidar Sharafi</name>
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<author><name sortKey="Ebrahimi Daryani, Nasser" sort="Ebrahimi Daryani, Nasser" uniqKey="Ebrahimi Daryani N" first="Nasser" last="Ebrahimi Daryani">Nasser Ebrahimi Daryani</name>
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</affiliation>
</author>
<author><name sortKey="Merat, Shahin" sort="Merat, Shahin" uniqKey="Merat S" first="Shahin" last="Merat">Shahin Merat</name>
<affiliation><nlm:aff id="aff101822">Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Mohraz, Minoo" sort="Mohraz, Minoo" uniqKey="Mohraz M" first="Minoo" last="Mohraz">Minoo Mohraz</name>
<affiliation><nlm:aff id="aff101805">Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Mardani, Masoud" sort="Mardani, Masoud" uniqKey="Mardani M" first="Masoud" last="Mardani">Masoud Mardani</name>
<affiliation><nlm:aff id="aff101806">Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Fattahi, Mohamad Reza" sort="Fattahi, Mohamad Reza" uniqKey="Fattahi M" first="Mohamad Reza" last="Fattahi">Mohamad Reza Fattahi</name>
<affiliation><nlm:aff id="aff101807">Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Poustchi, Hossein" sort="Poustchi, Hossein" uniqKey="Poustchi H" first="Hossein" last="Poustchi">Hossein Poustchi</name>
<affiliation><nlm:aff id="aff101822">Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Nikbin, Mehri" sort="Nikbin, Mehri" uniqKey="Nikbin M" first="Mehri" last="Nikbin">Mehri Nikbin</name>
<affiliation><nlm:aff id="aff101800">Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Nabavi, Mahmood" sort="Nabavi, Mahmood" uniqKey="Nabavi M" first="Mahmood" last="Nabavi">Mahmood Nabavi</name>
<affiliation><nlm:aff id="aff101808">Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Adibi, Peyman" sort="Adibi, Peyman" uniqKey="Adibi P" first="Peyman" last="Adibi">Peyman Adibi</name>
<affiliation><nlm:aff id="aff101809">Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Ziaee, Masood" sort="Ziaee, Masood" uniqKey="Ziaee M" first="Masood" last="Ziaee">Masood Ziaee</name>
<affiliation><nlm:aff id="aff101810">Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Behnava, Bita" sort="Behnava, Bita" uniqKey="Behnava B" first="Bita" last="Behnava">Bita Behnava</name>
<affiliation><nlm:aff id="aff101799">Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff101800">Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Rezaee Zavareh, Mohammad Saeid" sort="Rezaee Zavareh, Mohammad Saeid" uniqKey="Rezaee Zavareh M" first="Mohammad Saeid" last="Rezaee-Zavareh">Mohammad Saeid Rezaee-Zavareh</name>
<affiliation><nlm:aff id="aff101799">Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff101800">Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff101811">Student’s Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Colombo, Massimo" sort="Colombo, Massimo" uniqKey="Colombo M" first="Massimo" last="Colombo">Massimo Colombo</name>
<affiliation wicri:level="1"><nlm:aff id="aff101812">Department of Medicine, Gastroenterology Division 1, AM and A Migliavacca Center for the Study of Liver Disease, Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Department of Medicine, Gastroenterology Division 1, AM and A Migliavacca Center for the Study of Liver Disease, Ca’ Granda Ospedale Maggiore Policlinico, University of Milan</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Massoumi, Hatef" sort="Massoumi, Hatef" uniqKey="Massoumi H" first="Hatef" last="Massoumi">Hatef Massoumi</name>
<affiliation wicri:level="1"><nlm:aff id="aff101813">New York Associates in Gastroenterology, Bronx, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New York Associates in Gastroenterology, Bronx, New York</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bizri, Abdul Rahman" sort="Bizri, Abdul Rahman" uniqKey="Bizri A" first="Abdul Rahman" last="Bizri">Abdul Rahman Bizri</name>
<affiliation wicri:level="1"><nlm:aff id="aff101814">Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon</nlm:aff>
<country xml:lang="fr">Liban</country>
<wicri:regionArea>Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Eghtesad, Bijan" sort="Eghtesad, Bijan" uniqKey="Eghtesad B" first="Bijan" last="Eghtesad">Bijan Eghtesad</name>
<affiliation wicri:level="1"><nlm:aff id="aff101815">Cleveland Clinic, Cleveland, OH, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Cleveland Clinic, Cleveland, OH</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Amiri, Majid" sort="Amiri, Majid" uniqKey="Amiri M" first="Majid" last="Amiri">Majid Amiri</name>
<affiliation wicri:level="1"><nlm:aff id="aff101816">Gastroenterology and Hepatology Department, Gouin Hospital, Clichy, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Gastroenterology and Hepatology Department, Gouin Hospital, Clichy</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Namvar, Ali" sort="Namvar, Ali" uniqKey="Namvar A" first="Ali" last="Namvar">Ali Namvar</name>
<affiliation><nlm:aff id="aff101817">Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Hesamizadeh, Khashayar" sort="Hesamizadeh, Khashayar" uniqKey="Hesamizadeh K" first="Khashayar" last="Hesamizadeh">Khashayar Hesamizadeh</name>
<affiliation><nlm:aff id="aff101799">Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="aff101800">Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Malekzadeh, Reza" sort="Malekzadeh, Reza" uniqKey="Malekzadeh R" first="Reza" last="Malekzadeh">Reza Malekzadeh</name>
<affiliation><nlm:aff id="aff101822">Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran</nlm:aff>
<wicri:noCountry code="subfield">IR Iran</wicri:noCountry>
</affiliation>
</author>
</analytic>
<series><title level="j">Hepatitis Monthly</title>
<idno type="ISSN">1735-143X</idno>
<idno type="eISSN">1735-3408</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Context</title>
<p>Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran.</p>
</sec>
<sec><title>Evidence Acquisition</title>
<p>The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3<sup>rd</sup>
national consensus on management of Hepatitis C in Iran, held on 22<sup>nd</sup>
of July 2016.</p>
</sec>
<sec><title>Results</title>
<p>Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered.</p>
</sec>
<sec><title>Conclusions</title>
<p>Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection.</p>
</sec>
</div>
</front>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Hepat Mon</journal-id>
<journal-id journal-id-type="iso-abbrev">Hepat Mon</journal-id>
<journal-id journal-id-type="doi">10.5812/hepatmon</journal-id>
<journal-id journal-id-type="publisher-id">Kowsar</journal-id>
<journal-title-group><journal-title>Hepatitis Monthly</journal-title>
</journal-title-group>
<issn pub-type="ppub">1735-143X</issn>
<issn pub-type="epub">1735-3408</issn>
<publisher><publisher-name>Kowsar</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27799966</article-id>
<article-id pub-id-type="pmc">5075356</article-id>
<article-id pub-id-type="doi">10.5812/hepatmon.guideline</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Recommendations for the Clinical Management of Hepatitis C in Iran: A Consensus-Based National Guideline</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Alavian</surname>
<given-names>Seyed Moayed</given-names>
</name>
<xref ref-type="aff" rid="aff101799">1</xref>
<xref ref-type="aff" rid="aff101800">2</xref>
<xref ref-type="corresp" rid="cor101801">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hajarizadeh</surname>
<given-names>Behzad</given-names>
</name>
<xref ref-type="aff" rid="aff101802">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bagheri Lankarani</surname>
<given-names>Kamran</given-names>
</name>
<xref ref-type="aff" rid="aff101803">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sharafi</surname>
<given-names>Heidar</given-names>
</name>
<xref ref-type="aff" rid="aff101799">1</xref>
<xref ref-type="aff" rid="aff101800">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ebrahimi Daryani</surname>
<given-names>Nasser</given-names>
</name>
<xref ref-type="aff" rid="aff101804">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Merat</surname>
<given-names>Shahin</given-names>
</name>
<xref ref-type="aff" rid="aff101822">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mohraz</surname>
<given-names>Minoo</given-names>
</name>
<xref ref-type="aff" rid="aff101805">7</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mardani</surname>
<given-names>Masoud</given-names>
</name>
<xref ref-type="aff" rid="aff101806">8</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fattahi</surname>
<given-names>Mohamad Reza</given-names>
</name>
<xref ref-type="aff" rid="aff101807">9</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Poustchi</surname>
<given-names>Hossein</given-names>
</name>
<xref ref-type="aff" rid="aff101822">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nikbin</surname>
<given-names>Mehri</given-names>
</name>
<xref ref-type="aff" rid="aff101800">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nabavi</surname>
<given-names>Mahmood</given-names>
</name>
<xref ref-type="aff" rid="aff101808">10</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Adibi</surname>
<given-names>Peyman</given-names>
</name>
<xref ref-type="aff" rid="aff101809">11</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ziaee</surname>
<given-names>Masood</given-names>
</name>
<xref ref-type="aff" rid="aff101810">12</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Behnava</surname>
<given-names>Bita</given-names>
</name>
<xref ref-type="aff" rid="aff101799">1</xref>
<xref ref-type="aff" rid="aff101800">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rezaee-Zavareh</surname>
<given-names>Mohammad Saeid</given-names>
</name>
<xref ref-type="aff" rid="aff101799">1</xref>
<xref ref-type="aff" rid="aff101800">2</xref>
<xref ref-type="aff" rid="aff101811">13</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Colombo</surname>
<given-names>Massimo</given-names>
</name>
<xref ref-type="aff" rid="aff101812">14</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Massoumi</surname>
<given-names>Hatef</given-names>
</name>
<xref ref-type="aff" rid="aff101813">15</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bizri</surname>
<given-names>Abdul Rahman</given-names>
</name>
<xref ref-type="aff" rid="aff101814">16</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Eghtesad</surname>
<given-names>Bijan</given-names>
</name>
<xref ref-type="aff" rid="aff101815">17</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Amiri</surname>
<given-names>Majid</given-names>
</name>
<xref ref-type="aff" rid="aff101816">18</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Namvar</surname>
<given-names>Ali</given-names>
</name>
<xref ref-type="aff" rid="aff101817">19</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hesamizadeh</surname>
<given-names>Khashayar</given-names>
</name>
<xref ref-type="aff" rid="aff101799">1</xref>
<xref ref-type="aff" rid="aff101800">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Malekzadeh</surname>
<given-names>Reza</given-names>
</name>
<xref ref-type="aff" rid="aff101822">6</xref>
</contrib>
</contrib-group>
<aff id="aff101799"><label>1</label>
Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101800"><label>2</label>
Middle East Liver Diseases (MELD) Center, Tehran, IR Iran</aff>
<aff id="aff101802"><label>3</label>
Viral Hepatitis Clinical Research Program, The Kirby Institute, The University of New South Wales (UNSW Australia), Sydney, Australia</aff>
<aff id="aff101803"><label>4</label>
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran</aff>
<aff id="aff101804"><label>5</label>
Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101822"><label>6</label>
Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101805"><label>7</label>
Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101806"><label>8</label>
Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101807"><label>9</label>
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran</aff>
<aff id="aff101808"><label>10</label>
Department of Infectious Diseases and Tropical Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101809"><label>11</label>
Department of Gastroenterology and Hepatology, Isfahan University of Medical Sciences, Isfahan, IR Iran</aff>
<aff id="aff101810"><label>12</label>
Hepatitis Research Center, Birjand University of Medical Sciences, Birjand, IR Iran</aff>
<aff id="aff101811"><label>13</label>
Student’s Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR Iran</aff>
<aff id="aff101812"><label>14</label>
Department of Medicine, Gastroenterology Division 1, AM and A Migliavacca Center for the Study of Liver Disease, Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Italy</aff>
<aff id="aff101813"><label>15</label>
New York Associates in Gastroenterology, Bronx, New York, USA</aff>
<aff id="aff101814"><label>16</label>
Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon</aff>
<aff id="aff101815"><label>17</label>
Cleveland Clinic, Cleveland, OH, USA</aff>
<aff id="aff101816"><label>18</label>
Gastroenterology and Hepatology Department, Gouin Hospital, Clichy, France</aff>
<aff id="aff101817"><label>19</label>
Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, IR Iran</aff>
<author-notes><corresp id="cor101801"><label>*</label>
Corresponding Author: Seyed Moayed Alavian, Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-2181264070, E-mail: <email>alavian@thc.ir</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>13</day>
<month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><month>8</month>
<year>2016</year>
</pub-date>
<volume>16</volume>
<issue>8</issue>
<elocation-id>e40959</elocation-id>
<history><date date-type="received"><day>31</day>
<month>7</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>31</day>
<month>7</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2016, Kowsar Corp</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/"><license-p><pmc-comment>CREATIVE COMMONS</pmc-comment>
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>Context</title>
<p>Hepatitis C virus (HCV) infection is a major public health issue worldwide, including Iran. The new direct-acting antiviral agents (DAAs) with high efficacy have changed the landscape of HCV treatment. This guideline provides updated recommendations for clinical management of HCV infection in Iran.</p>
</sec>
<sec><title>Evidence Acquisition</title>
<p>The recommendations of this guideline are based on international and national scientific evidences and consensus-based expert opinion. Scientific evidences were collected through a systematic review of studies that evaluated efficacy and safety of DAA regimens, using PubMed, Scopus and Web of Science. Expert opinion was based on the consensus of Iran Hepatitis Scientific Board (IHSB) in the 3<sup>rd</sup>
national consensus on management of Hepatitis C in Iran, held on 22<sup>nd</sup>
of July 2016.</p>
</sec>
<sec><title>Results</title>
<p>Pegylated Interferon alpha (PegIFN), Ribavirin (RBV), Sofosbuvir (SOF), Ledipasvir (LDV) and Daclatasvir (DCV) are currently available in Iran. Pre-treatment assessments include HCV RNA level, HCV genotype and resistance testing, assessment of liver fibrosis, and underlying diseases. In HCV genotype 1 and 4, DCV/SOF and LDV/SOF are recommended. In HCV genotype 2, SOF plus RBV and in HCV genotype 3, DCV/SOF is recommended. Additional care for underlying diseases should be considered.</p>
</sec>
<sec><title>Conclusions</title>
<p>Affordable new HCV treatment regimens are available in Iran, providing an opportunity for HCV elimination. Recommendations provided in this current national guideline can facilitate evidence-based management of HCV infection.</p>
</sec>
</abstract>
<kwd-group kwd-group-type="author"><kwd>Hepatitis C</kwd>
<kwd>Therapy</kwd>
<kwd>Iran</kwd>
<kwd>Consensus</kwd>
<kwd>Disease Elimination</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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