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Remaining clinical issues in hepatitis C treatment
Alexander Wong1, Cynthia Tsien2, Sarah Mansour2
1Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Canadian Liver Journal
|August 22, 2022
Summary
Direct-acting antiviral (DAA) therapies have greatly improved hepatitis C virus (HCV) treatment outcomes, even for coinfected patients. However, questions about resistance, optimal use in liver disease, and cancer risk persist.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis C virus (HCV) infection management has been revolutionized by direct-acting antiviral (DAA) therapies.
- Interferon-free DAA regimens achieve high success rates, including in patients coinfected with HIV.
Purpose of the Study:
- To review current data and address unresolved clinical questions in HCV management.
- To explore the impact of viral resistance, DAA treatment outcomes, and hepatocellular carcinoma risk.
Main Methods:
- Review and interpretation of current scientific data.
- Discussion of pragmatic and clinically relevant management options for HCV.
Main Results:
- DAA therapies offer high cure rates for most HCV-infected individuals, including complex populations.
- Significant clinical questions regarding resistance, ribavirin use, and de novo/recurrent hepatocellular carcinoma risk remain.
Conclusions:
- While DAAs have transformed HCV care, further research is needed to optimize treatment strategies and address long-term outcomes.
- Clinical decision-making requires careful consideration of viral resistance, liver disease severity, and potential oncologic risks.
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