strictly economic reasons
Since there is “no evidence that the safety and effectiveness of DAAs against HCV vary by time of infection, the recommendation not to treat patients with less than 6 months of infection” is based on the following recommendations: strictly economic reasons” sighs the epidemiologist. Therefore, the sole purpose of his recommendations is “to reduce the cost of treatment in cases where certain immune responses can eliminate the virus and resolve the acute infection spontaneously”. From a medical perspective, most confirmed cases of acute HCV infection are Patients with a very high risk of spreading the infection in their environment: Multiple unprotected sexual encounters in a patient with a sexually transmitted infection or on HIV pre-exposure prophylaxis (PrEP). “Thus, any delay in initiation of HCV treatment implies a high risk of community transmission, an obstacle to achieving its elimination and facilitating the maintenance of cases in the aforementioned populations,” they assert in this regard.
Breaking the chain of epidemiological transmission
Guidelines produced by European Association for the Study of the Liver (EASL) and the latest GEHEP-GESIDA guidelines for HIV-infected persons with liver disease recommend that in the setting of sexually transmitted acute HCV infectiontreatment should be started immediately Its main goal is to break the epidemiological chain of transmission. “On the other hand, no studies have assessed the cost/benefit of delaying early treatment strategies in this population. Furthermore, we must not forget that HCV infection is a systemic infection that may develop extrahepatic disease at any time during its evolution. Complications,” they concluded.