Direct antiviral agent treatment of decompensated hepatitis C virus-induced liver cirrhosis

Abstract

Recently, direct antiviral agents (DAAs) have been increasingly used for the treatment of chronic hepatitis C virus (HCV) infections, replacing interferon-based regimens that have severe adverse effects and low tolerability. The constant supply of new DAAs makes shorter treatment periods with enhanced safety possible. The efficacy of DAAs for treatment of compensated liver cirrhosis (LC) is not less than that for treatment of non-cirrhotic conditions. These clinical advantages have been useful in pre-and post-liver transplantation (LT) settings. Moreover, DAAs can be used to treat decompensated HCV-induced LC in elderly patients or those with severe complications otherwise having poor prognosis. Although encouraging clinical data are beginning to appear, the actual efficacy of DAAs for suppressing disease progression, allowing delisting for LT and, most importantly, improving prognosis of patients with decompensated HCV-LC remains unknown. Casecontrol studies to examine the short-or long-term effects of DAAs for treatment of decompensated HCV-LC are urgently need.

Untreated alcohol use disorder in people who inject drugs (PWID) in France: a major barrier to HCV treatment uptake (the ANRS‐FANTASIO study)

“…The relationship we found between both cirrhosis (in the two analyses) and liver cancer (DAA era analysis) and HCV treatment uptake reflects: (i) the urgency for medical treatment; (ii) the fact that until mid‐2016, the use of DAA was restricted to patients with severe liver fibrosis or comorbidities ; and (iii) the fact that patients with decompensated cirrhosis could not undergo an IFN‐based regimen while DAA proved their effectiveness in such cases . These stringent initial criteria for DAA prescription probably explain the lower absolute incidence rate of treatment uptake we found in the DAA era than in the Peg‐IFN era.…”

HCV core protein inhibits polarization and activity of both M1 and M2 macrophages through the TLR2 signaling pathway

“…A remarkable evolution in HCV treatment with direct-acting antivirals (DAAs) drugs emerges, which has resulted in higher viral clearance rate22. We next investigated whether HCV reduction or eradication by DAAs therapy lead to the restoration of macrophages polarization.…”

Introductory Chapter: Liver Transplant in the Current Era

“…Most patients with decompensated liver fail to complete their course due to repeated hospitalization. Likewise, it has been found that the patients with decompensated liver have a lower SVR rate contrasted with less sick patients [16].…”