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Direct-acting antiviral agents in patients with hepatitis C cirrhosis

Gene Y Im1, Douglas T Dieterich1

  • 1Dr. Im is an Assistant Professor of Medicine in the Division of Liver Diseases, and Dr. Dieterich is a Professor of Medicine in the Division of Liver Diseases, Director of CME in the Department of Medicine, and Director of Outpatient Hepatology, all at Mount Sinai School of Medicine in New York, New York.

Gastroenterology & Hepatology
|March 28, 2014
PubMed

Insights

Hepatitis C virus (HCV) patients with cirrhosis need effective antiviral treatments. Direct-acting antiviral agents (DAAs) have improved cure rates, but challenges remain for those with advanced liver disease.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Patients with cirrhosis infected with hepatitis C virus (HCV) require effective antiviral therapy.
  • Virologic cure in these patients can improve fibrosis, enhance quality of life, and reduce liver-related complications.
  • Direct-acting antiviral agents (DAAs) have significantly increased cure rates for HCV genotype 1 infection.

Purpose of the Study:

  • To review the available data on HCV treatment in patients with cirrhosis.
  • To describe the evolution of HCV therapy from older treatments to the current era of DAAs.

Main Methods:

  • Review of published phase III direct-acting antiviral (DAA) trials.
  • Examination of data specifically pertaining to patients with cirrhosis.

Main Results:

  • Direct-acting antiviral agents (DAAs) have revolutionized HCV treatment, increasing cure rates.
  • Patients with advanced fibrosis or cirrhosis represent a challenging-to-treat population.
  • Existing DAA trial data for cirrhotic patients is limited.

Conclusions:

  • The advent of DAAs marks a new era in HCV therapy for patients with cirrhosis.
  • Further examination of DAA efficacy and safety in cirrhotic patients is warranted.
  • Understanding treatment evolution is crucial for optimizing care in this population.

Keywords:
Chronic hepatitis C virus infectionanemiaboceprevircirrhosisdecompensationdirect-acting antiviral agentsprotease inhibitorssustained virologic responsetelaprevir

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