Gut Liver.  2017 May;11(3):335-348. 10.5009/gnl15458.

Therapy with Direct-Acting Antiviral Agents for Hepatitis C-Related Liver Cirrhosis

Affiliations
  • 1Department of Hepatology, Kanazawa Medical University, Ishikawa, Japan. n.toshikuni@gmail.com

Abstract

Chronic hepatitis C virus (HCV) infection may eventually lead to liver cirrhosis (LC), a condition associated with a high risk of liver failure and hepatocellular carcinoma. Although interferon (IFN)-based therapy has made substantial contributions to the management of HCV-infected patients, this therapy has limitations for LC patients in terms of eligibility, tolerability, relatively low and high rates of sustained virological response (SVR), and serious adverse events. Therapy with newly developed direct-acting antiviral agents (DAAs) can overcome these limitations in IFN-based therapy. Recent phase 3 trials have demonstrated that DAA therapy achieved high SVR rates (more than 90% for genotype 1; 80% to 90% for genotype 2; 60% to 70% for genotype 3) for compensated LC patients, with high tolerability and relatively low rates of serious adverse events. Furthermore, trials have suggested that DAA therapy can be used for the treatment of decompensated LC patients as well as pretransplant and posttransplant LC patients. In this article, we review the current status of DAA therapy for HCV-related LC patients.

Keyword

Hepatitis C virus; Liver cirrhosis; Direct-acting antiviral agents

MeSH Terms

Antiviral Agents/*therapeutic use
Hepacivirus/drug effects
Hepatitis C, Chronic/complications/*drug therapy
Humans
Interferon-alpha/therapeutic use
Liver Cirrhosis/*drug therapy/virology
Sustained Virologic Response
Antiviral Agents
Interferon-alpha
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