Related Experiment Video
Updated: Mar 23, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Recent advances in managing chronic HCV infection: focus on therapy in patients with severe liver disease
Raoel Maan1, Adriaan J van der Meer1
1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, Rotterdam, 3015, Netherlands.
Insights
Direct-acting antivirals (DAAs) offer effective, interferon-free treatment for chronic hepatitis C virus (HCV) infection, shortening treatment duration. High costs necessitate prioritizing DAA therapy for patients with advanced liver disease and cirrhosis.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Chronic hepatitis C virus (HCV) infection remains a significant global health issue, causing substantial mortality.
- Direct-acting antivirals (DAAs) have revolutionized HCV treatment, offering improved efficacy and tolerability.
- Interferon (IFN)-free regimens are now available, significantly shortening treatment duration to 12 weeks for most patients.
Purpose of the Study:
- To review current interferon-free treatment options for patients with liver cirrhosis.
- To discuss the virological efficacy and clinical relevance of DAAs in this specific population.
- To address the challenges posed by the high cost of DAAs and the need for treatment prioritization.
Main Methods:
- Review of scientific literature on direct-acting antiviral (DAA) regimens for hepatitis C virus (HCV).
- Analysis of efficacy and safety data for IFN-free treatments in patients with cirrhosis.
- Discussion of treatment guidelines and cost-effectiveness considerations.
Main Results:
- DAA regimens are highly effective and well-tolerated in patients with advanced liver disease, including cirrhosis.
- Interferon-free therapy can achieve high viral eradication rates.
- High costs of DAAs present a barrier to widespread global access, requiring strategic prioritization.
Conclusions:
- Interferon-free DAA therapy represents a major advancement in managing chronic hepatitis C virus (HCV) infection, particularly for patients with cirrhosis.
- Prioritizing DAA treatment for patients with advanced liver disease is crucial due to their urgent need for viral clearance and the high cost of therapy.
- Further strategies are needed to improve global access to these life-saving treatments.
Abstract:
Chronic hepatitis C virus (HCV) infection still represents a major public health problem, as it is thought to be responsible for more than 350,000 deaths around the globe on a yearly basis. Fortunately, successful eradication of the virus has been associated with improved clinical outcome and reduced mortality rates. In the past few years, treatment has improved considerably by the implementation of direct-acting antivirals (DAAs). From 2014 onwards, sofosbuvir, simeprevir, daclatasvir, ledipasvir, paritaprevir, ombitasvir, and dasabuvir have been approved by the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). Regimens with various combinations of these new drugs, without the use of interferon (IFN), proved to be very effective and well tolerated, even among patients with advanced liver disease. Moreover, treatment duration could be shortened to 12 weeks in the majority of patients. The high costs of these DAAs, however, limit the availability of IFN-free therapy worldwide. Even in wealthy countries, it is deemed necessary to prioritize DAA treatment in order to limit the immediate impact on the health budget. As patients with advanced liver disease are in most need of HCV clearance, many countries decided to treat those patients first. In the current review, we focus on the currently available IFN-free treatment options for patients with cirrhosis. We discuss the virological efficacy as well as the clinical relevance of these regimens among this specific patient population.
More Related Videos
06:38An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
Published on: September 12, 2019
07:25Stem Cell-Derived Viral Ag-Specific T Lymphocytes Suppress HBV Replication in Mice
Published on: September 25, 2019
Related Concept Videos
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
01:25Hepatitis
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment