Concise review : interferon-free treatment of hepatitis C virus-associated cirrhosis and liver graft infection

  • Chronic hepatitis C is a major reason for development of cirrhosis and hepatocellular carcinoma and a leading cause for liver transplantation. The development of direct-acting antiviral agents lead to (pegylated) interferon-alfa free antiviral therapy regimens with a remarkable increase in sustained virologic response (SVR) rates and opened therapeutic options for patients with advanced cirrhosis and liver graft recipients. This concise review gives an overview about most current prospective trials and cohort analyses for treatment of patients with liver cirrhosis and liver graft recipients. In patients with compensated cirrhosis Child-Pugh-Turcotte (CTP) class A, all approved agents are safe and SVR rates do not significantly differ from patients without cirrhosis in general. In patients with decompensated cirrhosis CTP class B or C, daclastasvir, ledipasvir, velpatasvir, and sofosbuvir are approved, and SVR rates higher than 90% can be achieved. Especially for patients with a model of end stage liver disease score higher than 15 and therefore eligible for liver transplantation, data is scarce. Reported SVR rates in patients with cirrhosis CTP class C are lower compared to patients with a less severe liver disease. In liver transplant recipients with a maximum of CTP class A, SVR rates are comparable to patients without LT. Patients with decompensated graft cirrhosis should be treated on an individual basis.

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Author:Nina Weiler, Stefan ZeuzemORCiDGND, Martin-Walter WelkerGND
URN:urn:nbn:de:hebis:30:3-426031
DOI:https://doi.org/10.3748/wjg.v22.i41.9044
ISSN:2219-2840
ISSN:1007-9327
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/27895394
Parent Title (English):World journal of gastroenterology
Publisher:WJG Press
Place of publication:Beijing
Document Type:Article
Language:English
Date of Publication (online):2017/04/27
Year of first Publication:2016
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2017/04/27
Tag:cirrhosis; direct antiviral agents; hepatitis C; interferon-free antiviral treatment; liver transplantation
Volume:22
Issue:41
Page Number:14
First Page:9044
Last Page:9056
Note:
Copyright © The author(s) 1995-2017. Published by Baishideng Publishing Group Inc. All rights reserved. Articles published by this open-access journal are distributed under the terms of the Creative Commons Attribution-Noncommercial (CC BY-NC 4.0) License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
HeBIS-PPN:421388250
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0