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2015 ; 6
(6
): 314-27
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Strategies for treating chronic HCV infection in patients with cirrhosis: latest
evidence and clinical outcomes
#MMPMID26568808
Wilder JM
; Muir AJ
Ther Adv Chronic Dis
2015[Nov]; 6
(6
): 314-27
PMID26568808
show ga
The burden of chronic hepatitis C virus (HCV) infection is significant and
growing. HCV is considered one of the leading causes of liver disease worldwide
and the leading cause of liver transplantation globally. While those infected is
estimated in the hundreds of millions, this is likely an underestimation because
of the indolent nature of this disease when first contracted. Approximately 20%
of patients with HCV infection will progress to advanced fibrosis and cirrhosis.
Those that do are at risk of decompensated liver disease including GI bleeding,
encephalopathy, severe lab abnormalities, and hepatocellular carcinoma. Those
individuals with advanced fibrosis and cirrhosis have historically been difficult
to treat. The backbone of previous HCV regimens was interferon (IFN). The
outcomes for IFN based regimens were poor and resulted in increased adverse
events among those with advanced fibrosis and cirrhosis. Now, in the era of new
direct acting antiviral (DAA's) medications, there is hope for curing chronic HCV
in everyone, including those with advanced fibrosis and cirrhosis. This article
provides a review on the most up to date data on the use of DAA's in patients
with advanced fibrosis and cirrhosis. We are at a point where HCV could be truly
eradicated, but to do so will require ensuring there are effective and safe
treatments for those with advanced fibrosis and cirrhosis.