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Updated: Feb 1, 2026
Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
Published on: January 25, 2015
[Treatment of Hepatitis C: State of the Art 2018]
1Medizinische Klinik 1, Universitätsklinikum Frankfurt am Main.
Insights
Achieving a sustained virologic response for individuals and eliminating hepatitis C virus (HCV) globally are key goals. Modern antiviral therapies offer high cure rates and excellent tolerability.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV).
- Antiviral therapy is crucial for both individual patient recovery and population-level HCV eradication.
Purpose of the Study:
- To review current antiviral therapies for HCV.
- To discuss treatment strategies, drug interactions, and special patient populations.
Main Methods:
- Review of direct-acting antiviral agents targeting HCV RNA-dependent RNA-polymerase, NS3/4A protease, and NS5A.
- Analysis of pangenotypic regimens and considerations for specific patient groups.
Main Results:
- Pangenotypic regimens like sofosbuvir/velpatasvir and glecaprevir/pibrentasvir achieve >95% sustained virologic response rates.
- Treatment duration is typically 8-12 weeks, with excellent safety and tolerability.
- Contraindications and specific recommendations exist for patients with decompensated cirrhosis or renal insufficiency.
Conclusions:
- Modern interferon-free HCV therapies are highly effective and well-tolerated.
- Individualized treatment decisions must consider patient factors like hepatic/renal function and drug-drug interactions.
- Retreatment strategies are available for patients who have not responded to prior therapies.
Aims Of Antiviral Therapy:
Aim of antiviral therapy on an individual patient level is a sustained virologic response, on a population level the elimination of the hepatitis C virus (HCV). The latter is an aim also defined by the WHO.
Antiviral Drugs And Drug-Drug Interactions:
Specific inhibitors of the RNA-dependent RNA-polymerase, the NS3/4A protease, and the NS5A protein as well as ribavirin are available for antiviral therapy of HCV. Typically, two direct antiviral agents are combined, the treatment duration for the majority of patients is between 8 and 12 weeks. Potential drug-drug interactions with patients' basic medications must be assessed.
Pangenotypic And Genotype-Specific Regimens:
Two pangenotypic regimens are available: sofosbuvir/velpatasvir and glecaprevir/pibrentasvir. In the individual decision between regimens hepatic and renal function as well as drug-drug interactions must be considered. The sustained virologic response rates are above 95 %, safety and tolerability of the treatment regimens are excellent.
Treatment In Special Patient Populations:
In patients with decompensated cirrhosis treatment with protease inhibitors is contraindicated. Sofosbuvir is not approved in patients with severe renal insufficiency. Patients who failed an interferon-free therapy should be retreated with sofosbuvir/velpatasvir/voxilaprevir.
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