Chronic hepatitis C
Chronic viral liver disease caused by HCV. Since 2014, curable in the vast majority of patients with direct-acting antivirals (DAAs) – glecaprevir/pibrentasvir, sofosbuvir/velpatasvir, and others – in 8–12 weeks. Regimen is chosen by genotype and fibrosis stage.
ICD-10 B18.24 drugs
Also known as: HCV, Hepatitis C
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DSilymarin (Silybum marianum)Not recommended · Plant antioxidant from milk thistle fruits; IV silibinin is an antidote in Amanita phalloides poisoningSilymarin is an extract of milk thistle, promoted to protect the liver, including in chronic hepatitis C. Studies have not shown convincing benefit for this use: silymarin does not meaningfully change the course of the infection or the state of the liver, and there is no evidence base supporting it here. Chronic hepatitis C responds to direct-acting antiviral treatment, which cures most patients. Silymarin is harmless in this role, but taking it instead of treatment with proven benefit risks missing the care that actually works. A doctor chooses the regimen
- FGlycyrrhizic acid + phospholipidsNot recommended · Liver therapy (local classification, «hepatoprotectors»)Chronic hepatitis C is treated with direct-acting antivirals (DAAs), which achieve sustained virologic response in over 95% of patients. EASL 2020 and AASLD 2023 guidelines recommend only DAAs. Phosphogliv is not mentioned in these documents. Prescribing a hepatoprotector for chronic hepatitis C is a missed opportunity for cure.
- FInterferon α-2b in suppositoriesNot recommended · Interferons (suppositories, local classification)In chronic hepatitis C, rectal Viferon is not mentioned in AASLD/IDSA or EASL guidelines. The standard of care is direct-acting antivirals (DAAs) achieving sustained virological response above 95 %.
- FMeglumine acridone acetateNot recommended · Other immunostimulants (local classification)In chronic hepatitis C, Cycloferon is not mentioned in AASLD/IDSA HCV Guidance or EASL 2020. The standard of care is direct-acting antivirals (DAAs): sofosbuvir/velpatasvir, glecaprevir/pibrentasvir, and other combinations achieving sustained virological response above 95 % in 8–12 weeks.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit