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Management of hepatitis C patients with decompensated liver disease

Ching-Sheng Hsu1,2,3, Jia-Horng Kao4,5,6,7

  • 1a Division of Gastroenterology, Department of Internal Medicine , Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation , Taipei , Taiwan.

Expert Review of Gastroenterology & Hepatology
|January 20, 2016
PubMed

Insights

Novel oral direct-acting antivirals (DAA) show promise for treating hepatitis C virus (HCV) in patients with decompensated cirrhosis. Evidence supports the safety and effectiveness of these DAA regimens for HCV genotypes 1-4.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Decompensated cirrhosis poses unique challenges for hepatitis C virus (HCV) treatment.
  • Limited data exist on the safety and efficacy of novel oral direct-acting antivirals (DAA) in this patient population.

Purpose of the Study:

  • To review existing literature on the use of DAAs for HCV patients with decompensated cirrhosis.
  • To assess the tolerance and effectiveness of various DAA regimens.

Main Methods:

  • Comprehensive literature search of English articles from 1947 to August 2015.
  • Review of 14 articles focusing on HCV patients with decompensated cirrhosis.

Main Results:

  • Ledipasvir/sofosbuvir/ribavirin (LDV/SOF/RBV) for 12 weeks is safe and effective for HCV genotypes 1 or 4.
  • Daclatasvir/SOF/RBV for 12 weeks is safe and effective for HCV genotypes 1 or 4.
  • Daclatasvir/SOF/RBV for 12 weeks or SOF/RBV for 24 weeks may be effective and safe for HCV genotypes 2 or 3.

Conclusions:

  • Current evidence supports the use of all-oral DAA regimens in HCV patients with decompensated cirrhosis.
  • DAA regimens demonstrate favorable safety and efficacy profiles in this challenging patient group.

Keywords:
Antiviral agentsDirect acting antiviralsGenotypeHepatitis CHumanLiver failure

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