Cirrhosis regression in patients with viral hepatitis B and C: a systematic review

Area of Science:

• Hepatology
• Virology
• Gastroenterology

Background:

• Cirrhosis, a severe complication of chronic liver disease, significantly impacts patient morbidity and mortality.
• Chronic hepatitis B (CHB) and chronic hepatitis C (CHC) are leading causes of cirrhosis worldwide.
• The potential for reversing cirrhosis through sustained viral suppression remains a critical question in managing viral hepatitis.

Purpose of the Study:

• To systematically review existing literature on the reversibility of cirrhosis in viral hepatitis.
• To assess the impact of long-term viral suppression on cirrhotic liver histology.
• To evaluate the efficacy of antiviral therapies in achieving cirrhosis regression.

Main Methods:

• A comprehensive literature search was performed using MEDLINE and Cochrane Library databases.
• Fourteen relevant studies (4 on CHB, 10 on CHC) were included in the final analysis.
• Data extraction focused on patient demographics, antiviral treatments, treatment duration, and liver biopsy results.

Main Results:

• In chronic hepatitis B, cirrhosis regression was observed in a median of 70% of patients across 7 studies.
• In chronic hepatitis C, cirrhosis regression occurred in a median of 64% of patients with sustained virologic response across 13 studies.
• These findings indicate a significant potential for histological improvement in cirrhotic livers.

Conclusions:

• Viral suppression in CHB and sustained virologic response in CHC are associated with histologic regression of cirrhosis.
• Cirrhosis reversibility is achievable in select patients with viral hepatitis through effective antiviral therapy.
• These results highlight the importance of long-term viral control in managing advanced liver disease.