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Managing hepatitis C in patients with the complications of cirrhosis

Marcus M Mücke1, Victoria T Mücke1, Christian M Lange1

  • 1Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt, Germany.

Liver International : Official Journal of the International Association for the Study of the Liver
|February 11, 2018
PubMed

Insights

Direct acting antivirals (DAA) offer high cure rates for hepatitis C virus (HCV). However, managing HCV in patients with decompensated cirrhosis and assessing hepatocellular carcinoma (HCC) risk remain clinical challenges.

Area of Science:

  • Hepatology
  • Virology
  • Clinical Medicine

Background:

  • Direct acting antivirals (DAA) have transformed hepatitis C virus (HCV) treatment, achieving high sustained virological response (SVR) rates.
  • Managing HCV in patients with advanced liver disease, including decompensated cirrhosis, presents unique safety and efficacy challenges.
  • Hepatocellular carcinoma (HCC) development and management in the context of DAA therapy require careful consideration.

Purpose of the Study:

  • To review the current treatment landscape for HCV in patients with decompensated cirrhosis.
  • To evaluate the safety and efficacy of DAAs in this challenging patient population.
  • To discuss the potential risk of HCC development after DAA treatment.

Main Methods:

  • Literature review of clinical trials and observational studies.
  • Analysis of safety and efficacy data for various DAA regimens.
  • Assessment of risk factors and surveillance strategies for HCC.

Main Results:

  • DAAs demonstrate high efficacy in achieving SVR in patients with decompensated cirrhosis, though careful monitoring is needed.
  • Specific DAA regimens have established safety profiles in this population, with manageable adverse events.
  • The risk of HCC development post-treatment requires ongoing research and surveillance protocols.

Conclusions:

  • DAA therapy is effective and generally safe for HCV patients with decompensated cirrhosis.
  • Close monitoring for HCC development is crucial following successful HCV eradication.
  • Further research is needed to optimize treatment strategies and HCC surveillance in this cohort.

Keywords:
decompensated cirrhosisdifficult-to-treat patientshepatitis C virushepatocellular carcinoma

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