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ISBN: 2501030036 9782501030038 Year: 1999 Publisher: Bruxelles Marabout
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Publisher: Paris Garnier
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Year: 1897 Publisher: S.l. : s.n.,
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ISBN: 9067891770 Year: 1990 Publisher: Amsterdam Addison-Wesley
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ISBN: 9063981791 Year: 1990 Publisher: Oosterend : Stark-Texel,
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Year: 2012 Publisher: Rockville, Maryland : Agency for Healthcare Research and Quality (US),
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Year: 2016 Publisher: Bruxelles: UCL. Faculté de santé publique,
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Less than 25 years after its discovery, Hepatitis C is handled in an unprecedented manner. Indeed, new treatments specifically targeting key steps of the viral replication cycle put an end to the prevailing therapeutic approach, which advocates the subcutaneous inoculation of interferon. These treatments, broadly known as “Direct acting antivirals”, are characterized by an increased effectiveness, an oral administration suited for the patient’s pathological stage, and an optimal safety profile compared to the older therapies. While these new medications seem to meet all the requirements to reach the total eradication of hepatitis C, which causes the deaths of over 300,000 people each year, the final picture is much more ambiguous. As a matter of fact, challenges have emerged and more will in the future. While such challenges are scientific, they are mainly extra-scientific, involving the high price of these new therapies, for example. This master’s thesis aims to point out the real breakthroughs this new therapeutic era brings into the care of patients living with chronic Hepatitis C, whilst trying to describe new perspectives regarding the remaining issues. Moins de 25 ans après la découverte du virus, la prise en charge de l'hépatite C connait une révolution sans précédent. En effet, de nouveaux traitements ciblant spécifiquement les étapes clés du cycle de réplication virale ont mis un terme aux conventions thérapeutiques standards recommandant l'utilisation d'interféron par voie sous-cutanée. Ces traitements communément appelés « antiviraux à action directe » se caractérisent notamment par une efficacité majorée, une administration orale aisée et adaptée au stade pathologique du patient ainsi qu'un profil de sécurité optimal face aux anciennes thérapies. Si ces nouvelles médications semblent dès lors offrir tous les éléments requis pour atteindre une éradication pure et simple de ce virus entrainant le décès annuel de plus de 300 000 personnes, le tableau final s'avère toutefois plus nuancé. De fait, plusieurs défis actuels et en devenir ont émergé. Ceux-ci sont d'ordre scientifique mais en réalité davantage extrascientifique et concernent notamment le prix prohibitif de ces nouvelles thérapies. Ce mémoire a donc pour objectif de mettre en exergue les réelles avancées qu'apporte cette nouvelle ère thérapeutique dans la prise en charge des patients atteints d'hépatite C chronique, tout en tentant d'apporter certaines perspectives quant à la réalisation des défis résiduels illustrés au sein de ce travail.
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