Tuesday, September 29, 2015

Full Text: HCV targeting of patients with cirrhosis

October 2015
Volume 63, Issue 4, Pages 1015–1022

HCV targeting of patients with cirrhosis
Peter Ferenci, Karin Kozbial , Mattias Mandorfer , Harald Hofer Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria  

Received: March 11, 2015; Received in revised form: June 9, 2015; Accepted: June 10, 2015; Published Online: June 19, 2015 Article has an altmetric score of 10
DOI: http://dx.doi.org/10.1016/j.jhep.2015.06.003

[Free review] @ Journal Of Hepatology

Interferon (IFN)-free treatments are now the treatment of choice for patients with chronic hepatitis C. Previously difficult to treat patients by IFN-containing treatments can now be treated safely by IFN-free therapies. More than 90% of hepatitis C genotype 1 and 4 patients with compensated cirrhosis or after orthotopic liver transplantation (OLT) can be cured by sofosbuvir combined with simeprevir, daclatasvir or ledipasvir, or by the paritaprevir/ritona-vir/ombitasvir/±dasabuvir (3D) combination. Addition of ribavirin confers to a minimal, if any, benefit to increase SVR. The need for ribavirin is controversial and remains to be studied. The optimal length of treatment is still unknown, and an individual approach may be needed. Most patients require only 12 weeks of therapy. The safety of these drugs is not fully explored in patients with decompensated cirrhosis (Child-Pugh C), who should not be treated with protease inhibitors. In cirrhosis hepatitis C virus eradication does not necessarily mean a cure of the disease and patients regularly require follow-up. Drug-drug interactions with immunosuppressant in patients after OLT are easier to manage but still require attention. Better drugs are needed for genotype 3 patients

Table 1
Impact of treatment duration and addition of ribavirin on the response to IFN-free treatments in patients with cirrhosis due to HCV-GT1 infection.

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© 2015 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.

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