Hepatitis C is now curable, but what happens with cirrhosis and portal hypertension afterwards?

Clinical and Experimental Hepatology

Review paper
Hepatitis C is now curable, but what happens with cirrhosis and portal hypertension afterwards?
Ivica Grgurevic, Tonci Bozin, Anita Madir
Clin Exp HEPATOL 2017; 3, 4: 181-186
DOI: https://doi.org/10.5114/ceh.2017.71491

Introduction

The appearance of direct-acting antivirals (DAA) in 2011 marked the beginning of a new era in hepatitis C treatment. Since 2014, ‘all-oral therapy’ has been introduced, with nearly a 100% successful eradication rate for the hepatitis C virus (HCV) achieved, including cirrhotic patients [1]. It has been well documented that viral clearance upon receiving therapy generally results in reduced morbidity and mortality from chronic liver disease [2], but how this influences clinical outcomes in patients with already established cirrhosis and portal hypertension (PH), as the most endangered cohort, is a matter of debate. In other words, does the HCV cure translate into halting the progression of liver disease, and does it lead to the reversal of cirrhosis into lower histological stages and regression of PH? The theoretical background that allows for these issues to be addressed has only recently been established, characterized by the modern concept that views cirrhosis and PH as dynamic processes in the context of advanced chronic liver disease [3].

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