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Discovered in 1989 by Choo and collaborators thanks to the advent of molecular biology methods, hepatitis C virus causes a disease which can lead to hepatic decompensation, cirrhosis and hepatocellular carcinoma. More than a decade ago, the reference treatment for this disease was based on dual therapy comprising peg-IFN/Ribavirin because it offered a sustained virological response (SVR) of about 50% of treated. Recently, research and scientific progress have led to the discovery of new molecules, also known as direct acting antivirals (DAAs). This work summarizes the convincing results of clinical trials concerning the efficacy, the tolerance and the safety of these drugs that belong to several therapeutic classes such as NS3/4A protease inhibitors (simeprevir, paritaprevir), NS5B polymerase inhibitors (sofosbuvir, dasabuvir) and NS5A inhibitors (daclatasvir, ombitasvir). The DAAs described in this work, as well as the most recently released, have achieved better results, including an increase in the cure rate (SVR around 90%) and a reduction in the duration of treatment at 12 weeks. Unfortunately, because of the exorbitant price of these medicines, not all patients suffering from this disease receive therapeutic coverage. Much remains to be done in terms of these new molecules, so that the health insurance covers as soon as possible the treatment of all patients. Découvert en 1989 par Choo et collaborateur grâce à l'avènement des techniques de biologie moléculaire, le virus de l'hépatite C entraine une maladie qui peut conduire à une décompensation hépatique, à des cas de cirrhose et de carcinome hépatocellulaire. Il y a plus d'une dizaine d'année, le traitement de référence de cette maladie était encore basée sur la bithérapie peg-IFN I Ribavirine car elle offrait une réponse virologique soutenue (RVS) d'environ 50% des cas. Depuis peu, la recherche et les progrès scientifiques ont conduit à la découverte de nouvelles molécules encore appelées antiviraux à action directe (AAD). Ce travail de mémoire résume les résultats convaincant des essais cliniques concernant l’efficacité, la tolérance et la sécurité de ces médicaments qui comptent plusieurs classes thérapeutiques comme les inhibiteurs de la protéase NS3/4A (simeprevir, paritaprevir), les inhibiteurs de la polymérase NS5B (sofosbuvir, dasabuvir) et les inhibiteurs de NS5A (daclatasvir, ombitasvir). Les AAD décrits ce travail ainsi que les plus récemment mis sur le marché, ont permis d'obtenir de meilleurs résultats notamment une augmentation du taux de guérison (RVS aux alentours de 90%) et une diminution de la durée du traitement à 12 semaines. Malheureusement, à cause du prix exorbitant de ces médicaments, tous les patients souffrant de cette maladie ne bénéficient pas d'une couverture thérapeutique. Beaucoup reste donc à faire au niveau de la politique gouvernementale de chaque pays en ce qui concerne la pharmaco-médico-économie de ces nouvelles molécules, afin que l'assurance maladie prenne en charge le plus tôt possible le traitement de tous les patients.

Hepatitis C

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Modern C++ at your fingertips! About This Book This book gets you started with the exciting world of C++ programming It will enable you to write C++ code that uses the standard library, has a level of object orientation, and uses memory in a safe and effective way It forms the basis of programming and covers concepts such as data structures and the core programming language Who This Book Is For A computer, an internet connection, and the desire to learn how to code in C++ is all you need to get started with this book. What You Will Learn Get familiar with the structure of C++ projects Identify the main structures in the language: functions and classes Feel confident about being able to identify the execution flow through the code Be aware of the facilities of the standard library Gain insights into the basic concepts of object orientation Know how to debug your programs Get acquainted with the standard C++ library In Detail C++ has come a long way and is now adopted in several contexts. Its key strengths are its software infrastructure and resource-constrained applications, including desktop applications, servers, and performance-critical applications, not to forget its importance in game programming. Despite its strengths in these areas, beginners usually tend to shy away from learning the language because of its steep learning curve. The main mission of this book is to make you familiar and comfortable with C++. You will finish the book not only being able to write your own code, but more importantly, you will be able to read other projects. It is only by being able to read others' code that you will progress from a beginner to an advanced programmer. This book is the first step in that progression. The first task is to familiarize you with the structure of C++ projects so you will know how to start reading a project. Next, you will be able to identify the main structures in the language, functions, and classes, and feel confident being able to identify the execution flow through the code. You will then become aware of the facilities of the standard library and be able to determine whether you need to write a routine yourself, or use an existing routine in the standard library. Throughout the book, there is a big emphasis on memory and pointers. You will understand memory usage, allocation, and access, and be able to write code that does not leak memory. Finally, you will learn about C++ classes and get an introduction to object orientation ...

C++ (Computer program language)

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Presents the text of letters written in 1862 by United States Civil War soldier C.W. Scott to Hannah M. Cone. Descriptions of life as a soldier; Movements of his regiment through Missouri; Other comments.

Letters. --- Scott, C. W.

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Washington (D.C.) --- History.

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Presents the text of letters written in 1862 by United States Civil War soldier C.W. Scott to Hannah M. Cone. Descriptions of life as a soldier; Movements of his regiment through Missouri; Other comments.

Letters. --- Scott, C. W.