Sex-oriented diagnosis and therapy of hepatitis C

Chronic liver disease progresses at unequal rates in the 2 sexes both in viral hepatitis and in liver injury of different etiology. Fibrosis and/or cirrhosis develop earlier and are more severe in men than they are in women. Estrogens are supposed to have a protective role in preventing progression of liver injury toward fibrosis. This has been shown to be true in experimental models and in clinical studies. The experimental and clinical data also support the view that the course of hepatitis C and the response to therapy are heavily influenced by sex. In designing future clinical trials, this should be taken into account as the sustained response rate cannot be expected to be comparable between the 2 sexes, and for that matter within the female sex (ie, in fertile vs menopausal women). Care should be taken to enroll a suitable number of women and to stratify them by reproductive status. © 2013 FBCommunication s.r.l. a socio unico.