A REVIEW ARTICLE : PENATALAKSANAAN TERAPI HCV YANG EFEKTIF DAN AMAN

Authors

  • Lalu Denendra Praditama Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram
  • Baiq Putri Maharani Bine Inggit Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram
  • Weny Syafitri Utari Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram
  • Dhea Rizma Demula Putri Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram
  • Laili Aurelia Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram
  • Siti Rahmatul Aini Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram
  • Nurhidayati Nurhidayati Fakultas Kedokteran dan Ilmu Kesehatan Universitas Mataram

DOI:

https://doi.org/10.31004/jkt.v6i3.48995

Keywords:

Efektivitas, HCV, Keamanan, Terapi, Virus Hepatitis C

Abstract

Pendahuluan: Virus Hepatitis C (HCV) adalah patogen yang umumnya ditularkan melalui darah, terutama melalui penggunaan narkoba suntik. Tujuan: Tinjauan pustaka ini ditulis untuk menentukan manajemen terapi yang efektif dan aman bagi penderita HCV. Metode: Penelusuran dan pencarian artikel ulasan dilakukan melalui laman Proquest, Google Scholar, Kementerian Kesehatan, Pubmed, dan ScienceDirect. Kata kunci yang digunakan adalah “Manajemen Terapi”, “Virus Hepatitis C (HCV)”, “Management Therapy”, dan “Tatalaksana”, dengan hasil terdapat 13 artikel ulasan yang digunakan dalam periode waktu 2018-2023. Hasil: Penatalaksanaan terapi HCV melibatkan golongan obat DAA dengan tiga kelas obat utama, yaitu inhibitor protease NS3/4A, inhibitor protein NS5A, dan analog inhibitor polimerase NS5B. Sinergi Metformin dan DAA efektif dalam mengurangi manifestasi infeksi HCV kronis. Glecaprevir/Pibrentasvir pada pasien dengan gangguan ginjal berat menunjukkan tingkat kemanjuran yang tinggi dan toleransi yang baik. Meskipun, DAA efektif (95% menyembuhkan), namun potensi kegagalan terapi (3-5%) juga dapat terjadi. Hal ini dapat disebabkan oleh tingkat kepatuhan pasien dalam menjalani terapi, ketidaktepatan rejimen obat, dan resistensi virus akibat mutasi. Kesimpulan: Manajemen terapi HCV membutuhkan strategi lebih lanjut untuk memaksimalkan keberhasilan terapi yang efektif dan aman, serta upaya evaluasi secara berkala pada varian mutasi HCV untuk meningkatkan pemilihan rejimen obat DAA yang tepat.

References

Abdel-Gawad, M., Nour, M., El-Raey, F., Nagdy, H., Almansoury, Y., & El-Kassas, M. (2023). Gender differences in prevalence of hepatitis C virus infection in Egypt: a systematic review and meta-analysis. Scientific Reports, 13(1), 1–10. https://doi.org/10.1038/s41598-023-29262-z

Abubakarr, A., Gunawan, A., & Sari, J. (2023). Keberhasilan Tatalaksana Infeksi Virus Hepatitis C di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh. Journal of Medical Science, 3(2), 121–127. https://doi.org/10.55572/jms.v3i2.87

Bhattacharjee, C., Singh, M., Das, D., Chaudhuri, S., & Mukhopadhyay, A. (2021). Current therapeutics against HCV. ViruDisease, 32(2), 228–243. https://doi.org/10.1007/s13337-021-00697-0

Butt, A. A., Yan, P., Shuaib, A., Abou-Samra, A. B., Shaikh, O. S., & Freiberg, M. S. (2019). Direct-Acting Antiviral Therapy for HCV Infection Is Associated With a Reduced Risk of Cardiovascular Disease Events. Gastroenterology, 156(4), 987-996.e8. https://doi.org/10.1053/j.gastro.2018.11.022

Cho, A. (2019). Evolution of HCV NS5B Nucleoside and Nucleotide Inhibitors. Topics in Medicinal Chemistry, 31, 117–139. https://doi.org/10.1007/7355_2018_36

Dipiro, J. T., Yee, G. C., Posey, L. M., Haines, S. T., Nolin, T. D., & Ellingrod, V. (2020). Pharmacotherapy A Pathophysiologic Approach 11th Edition. In Pharmacotherapy A Pathophysiologic Approach.

Di Stefano, M., Faleo, G., Farhan Mohamed, A. M., Morella, S., Bruno, S. R., Tundo, P., Fiore, J. R., & Santantonio, T. A. (2021). Resistance associated mutations in HCV patients failing DAA treatment. New Microbiologica, 44(1), 12–18.

Dultz, G., Müller, T., Petersen, J., Mauss, S., Zimmermann, T., Muche, M., Simon, K. G., Berg, T., Zeuzem, S., Hüppe, D., Böker, K., Wedemeyer, H., Welzel, T. M., Günther, R., Hinrichsen, H., Heyne, R., Roth, J., Goeser, T., Ullrich, R., Schirmacher, P. (2018). Effectiveness and Safety of Direct-Acting Antiviral Combination Therapies for Treatment of Hepatitis C Virus in Elderly Patients: Results from the German Hepatitis C Registry. Drugs and Aging, 35(9), 843–857. https://doi.org/10.1007/s40266-018-0572-0

Droc, G., Istrate, M., Mercan-Stanci, A., Dodot, M., Isac, T., Toma, L., Zgura, A., Trifan, A., Serbanica, A. N., Iliescu, L., & Micu, L. (2022). Safety and Efficacy of Direct-acting Antiviral Therapies for Chronic HCV Infection in Hemodialysis Patients. In Vivo, 36(6), 2918–2922. https://doi.org/10.21873/invivo.13033

Elbaz, T., Abdo, M., Omar, H., Hassan, E. A., Zaghloul, A. M., Abdel-Samiee, M., Moustafa, A., Qawzae, A., Gamil, M., & Esmat, G. (2019). Efficacy and safety of sofosbuvir and daclatasvir with or without ribavirin in elderly patients with chronic hepatitis C virus infection. Journal of Medical Virology, 91(2), 272–277. https://doi.org/10.1002/jmv.25287

Fatimah, A. T. S., L, D. R., & Afdhal, A. F. (2022). Efektivitas Terapi Dan Efisiensi Biaya Pasien Hepatitis C Dengan Antivirus DAA Di RSUD Jakarta Selatan. Jurnal Endurance, 6(3), 590–601. https://doi.org/10.22216/jen.v6i3.602

Ganta, N. M., Gedda, G., Rathnakar, B., Satyanarayana, M., Yamajala, B., Ahsan, M. J., Jadav, S. S., & Balaraju, T. (2019). A review on HCV inhibitors: Significance of non-structural polyproteins. European Journal of Medicinal Chemistry, 164, 576–601. https://doi.org/10.1016/j.ejmech.2018.12.045

Hayes, C. N., Imamura, M., Tanaka, J., & Chayama, K. (2022). Road to elimination of HCV: Clinical challenges in HCV management. Liver International, 42(9), 1935–1944. https://doi.org/10.1111/liv.15150

Hopkins, L., Dunlap, T., & Cline, H. (2020). Pharmacology Update for the Treatment of Hepatitis C Virus. Nursing Clinics of North America, 55(3), 347–359. https://doi.org/10.1016/j.cnur.2020.06.008

Health Research and Development Agency (2018) Riskesdas National Report. Jakarta: Publishing Agency for Health Research and Development Agency.

Jhaveri, M. A., Manne, V., & Kowdley, K. V. (2018). Chronic Hepatitis C in Elderly Patients: Current Evidence with Direct-Acting Antivirals. Drugs and Aging, 35(2), 117–122. https://doi.org/10.1007/s40266-017-0515-1

Kamel, S., Elessawy, H., Ashraf, O., Elbaz, A., Dabbous, H., El-Sayed, M., Ali, S., & Kamel, H. (2021). Effectiveness of direct-acting antivirals in treatment of elderly Egyptian chronic hepatitis c patients. Gastroenterology Insights, 12(3), 336–346. https://doi.org/10.3390/GASTROENT12030031

Kemenkes RI. 2019. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Hepatitis C. Jakarta : Kementerian Kesehatan Republik Indonesia.

Khosa, G., Aziz, M. T., Suleman, H., Hussain, I., Abu-Talib, M., & Joya, S. J. (2021). Risk Factors and Treatment Outcome of Children With Hcv Infection. Journal of Ayub Medical College, 33(3), 403–407.

Lin, D., Reddy, V., Osman, H., Lopez, A., Koksal, A. R., Rhadhi, S. M., Dash, S., & Aydin, Y. (2021). Additional inhibition of wnt/β-catenin signaling by metformin in daa treatments as a novel therapeutic strategy for hcv-infected patients. Cells, 10(4), 1–16. https://doi.org/10.3390/cells10040790

Papic, N., Budimir, J., Kurelac, I., Dušek, D., Jugović, D., Krajcar, N., & Vince, A. (2018). Treatment of elderly patients with chronic hepatitis C: A retrospective cohort study. Acta Clinica Croatica, 57(1), 61–70. https://doi.org/10.20471/acc.2018.57.01.07

Pawlotsky, J. M., Negro, F., Aghemo, A., Berenguer, M., Dalgard, O., Dusheiko, G., Marra, F., Puoti, M., & Wedemeyer, H. (2020). EASL recommendations on treatment of hepatitis C: Final update of the series. Journal of Hepatology, 73(5), 1170–1218. https://doi.org/10.1016/j.jhep.2020.08.018

Shanmugam, S., Nichols, A. K., Saravanabalaji, D., Welsch, C., & Yi, M. K. (2018). HCV NS5A dimer interface residues regulate HCV replication by controlling its self-interaction, hyperphosphorylation, subcellular localization and interaction with cyclophilin A. In PLoS Pathogens, 14 (7).https://doi.org/10.1371/journal.ppat.1007177

Susilo, S. A., & Saputra, A. H. (2023). Terapi Kombinasi Sofosbuvir dan Daclatasvir Pada Pasien dengan Hepatitis C Kronik : Sebuah Tinjauan Literatur. Health Information : Jurnal Penelitian Terapi, 1–6.

Toyoda, H., Atsukawa, M., Uojima, H., Nozaki, A., Tamai, H., Takaguchi, K., Fujioka, S., Nakamuta, M., Tada, T., Yasuda, S., Chuma, M., Senoh, T., Tsutsui, A., Yamashita, N., Hiraoka, A., Michitaka, K., Shima, T., Akahane, T., Itobayashi, E., Kumada, T. (2019). Trends and efficacy of interferon-free anti–hepatitis C virus therapy in the region of high prevalence of elderly patients, cirrhosis, and hepatocellular carcinoma: A real-world, nationwide, multicenter study of 10 688 patients in Japan. Open Forum Infectious Diseases, 6(5). https://doi.org/10.1093/ofid/ofz185

WHO. Hepatitis C . World Health Organization. July 2023; [accessed 19 December 2023]. Available at: http://www.who.int.

Yap, D. Y. H., Liu, K. S. H., Hsu, Y. C., Wong, G. L. H., Tsai, M. C., Chen, C. H., Hsu, C. S., Hui, Y. T., Li, M. K. K., Liu, C. H., Kan, Y. M., Yu, M. L., & Yuen, M. F. (2020). Use of glecaprevir/pibrentasvir in patients with chronic hepatitis c virus infection and severe renal impairment. Clinical and Molecular Hepatology, 26(4), 554–561. https://doi.org/10.3350/cmh.2020.0058

Yen, H. H., Su, P. Y., Liu, I. L., Zeng, Y. Y., Huang, S. P., Hsu, Y. C., Yang, C. W., & Chen, Y. Y. (2021). Direct-Acting antiviral treatment for Hepatitis C Virus in geriatric patients: A real-world retrospective comparison between early and late elderly patients. PeerJ, 9, 1–15. https://doi.org/10.7717/peerj.10944

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Published

2025-09-24

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Vol. 6 No. 3 (2025): SEPTEMBER 2025

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Articles

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Copyright (c) 2025 Lalu Denendra Praditama, Baiq Putri Maharani Bine Inggit, Weny Syafitri Utari, Dhea Rizma Demula Putri, Laili Aurelia, Siti Rahmatul Aini, Nurhidayati Nurhidayati

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