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Treatment of chronic hepatitis C in patients with cirrhosis

Tianyan Chen1, Norah Terrault

  • 1Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, California, USA.

Current Opinion in Gastroenterology
|March 30, 2016
PubMed

Insights

Direct-acting antiviral therapies offer a well-tolerated and effective cure for hepatitis C virus (HCV) cirrhosis, improving liver health and reducing mortality. Treatment optimization and safety monitoring are crucial for patients with advanced liver disease.

Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Hepatitis C virus (HCV) infection in cirrhotic patients presents significant management challenges.
  • Direct-acting antivirals (DAAs) represent a paradigm shift in HCV treatment.

Purpose of the Study:

  • To review treatment options for HCV cirrhosis using approved and emerging DAAs.
  • To assess the efficacy and safety of DAA-based therapies in this population.

Main Methods:

  • Review of current literature on DAA therapies for HCV cirrhosis.
  • Analysis of treatment outcomes, including viral cure, fibrosis progression, and long-term benefits.
  • Evaluation of safety concerns and treatment decision factors.

Main Results:

  • DAA therapies are well-tolerated and highly effective for achieving viral cure in compensated and decompensated cirrhosis.
  • Viral eradication may arrest or reverse fibrosis, reduce liver decompensation, hepatocellular carcinoma, and mortality.
  • Optimizing treatment may require longer durations or complex drug combinations; treatment decisions depend on genotype, renal function, drug interactions, and cirrhosis severity.

Conclusions:

  • High-potency DAAs have transformed HCV-infected cirrhotic patients from 'difficult-to-treat' to a manageable group.
  • Understanding pretreatment factors predicting clinical outcomes is essential for personalized treatment strategies.
Abstract

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