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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Fibrosis reversal after hepatitis C virus elimination
1Department of Internal Medicine, The Medical University of South Carolina, Charleston, USA.
Insights
Hepatitis C virus (HCV) infection can lead to liver cirrhosis. However, direct-acting antiviral (DAA) drugs offer nearly 100% cure rates, promoting fibrosis reversion in many patients.
Area of Science:
- Hepatology
- Virology
- Gastroenterology
Background:
- Hepatitis C virus (HCV) infection is a primary cause of cirrhosis in the U.S.
- Direct-acting antiviral (DAA) drugs have revolutionized HCV treatment with high cure rates.
Purpose of the Study:
- To review recent findings on fibrosis reversion after HCV clearance.
- To assess the impact of DAAs on liver fibrosis and cirrhosis.
Main Methods:
- Review of existing literature on HCV therapy and fibrosis.
- Analysis of data from interferon-based and DAA treatment eras.
Main Results:
- HCV eradication, both with interferon and DAAs, leads to fibrosis reversal.
- DAA therapy results in rapid viral clearance and reduced inflammation.
- Emerging data suggest even cirrhosis can reverse in some patients post-HCV clearance.
Conclusions:
- Fibrosis and cirrhosis reversion occur after HCV clearance.
- Further research is needed to fully understand the extent and long-term implications of fibrosis reversion.
Purpose Of Review:
Hepatitis C virus (HCV) infection has been the leading cause of cirrhosis in the United States now for the last several decades. With the introduction of highly effective direct acting antiviral (DAA) drugs, cure rates are now almost 100%. With this explosion of effective therapy, it is possible that many patients with HCV may have reversion in fibrosis. The purpose of this review is, therefore, to report on recent findings in this field.
Recent Findings:
Older data that examined the effect of interferon-based HCV therapy indicate that fibrosis reverses after HCV eradication. More recent work in the DAA era similarly indicates that fibrosis is reversible. A caveat is that DAA therapy causes rapid viral clearance, and appears to lead to rapid reductions in inflammation. Some tools (such as transient elastography), which may also reflect the inflammatory response, and thus may 'overestimate' of fibrosis reversal. However, emerging data suggesting improved outcomes in patients with cirrhosis after HCV clearance support the concept that even cirrhosis reverses in some patients.
Summary:
Fibrosis (and cirrhosis) reversion, to some extent, occurs after HCV clearance. This topic is vitally important and information continues to emerge; more data on this subject are expected and needed.
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