Eradication of Hepatitis C Virus Infection and the Development of Hepatocellular Carcinoma

Morgan, Rebecca L.; Baack, Brittney N.; Smith, Bryce D.; Yartel, Anthony; Pitasi, Marc A.; Falck‐Ytter, Yngve

doi:10.7326/0003-4819-158-5-201303050-00005

Cited by 792 publications

(675 citation statements)

References 65 publications

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“…4,5 Eradication of HCV with antiviral therapy reduces the risk of hepatic decompensation, hepatocellular carcinoma, and death from a liver-related cause or any cause. [6][7][8][9][10] Among patients with HCV infection and cirrhosis in whom peginterferon-ribavirin treatment has failed, rates of sustained virologic response to retreatment with interferon-containing regimens are as low as 14%. [11][12][13][14][15][16][17][18][19] In addition, treatment for HCV infection, especially with interferoncontaining regimens, in patients with cirrhosis is associated with increased toxic effects.…”

Section: Discussionmentioning

confidence: 99%

ABT-450/r–Ombitasvir and Dasabuvir with Ribavirin for Hepatitis C with Cirrhosis

et al. 2014

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Section: Discussionmentioning

confidence: 99%

ABT-450/r–Ombitasvir and Dasabuvir with Ribavirin for Hepatitis C with Cirrhosis

et al. 2014

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“…11,12 Populations at higher risk for liver disease progression, Metavir F2, co-infection populations (HIV, Hepatitis B), those with coexistent liver disease (NASH or alcoholic) and patients with extra hepatic manifestations are not regularly listed in the Medicaid initial treatment considerations criteria. Those populations should be prioritized as per expert recommendations.…”

Section: Discussionmentioning

confidence: 99%

The Prescribers’ Dilemma: Treatment of Hepatitis C Infection for Medicaid Insured Patients in United States

Khallafi¹,

George²,

Qureshi³

2015

Liver Res Open J

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Introduction of Direct Acting Antivirals (DAA) to Hepatitis C Virus (HCV) treatment armamentarium has offered a great boost to the providers' confidence to safely and effectively treat HCV infection in the majority of patients. However, the cost of these medications is high and thus access is poor. Medicaid insurance providers have devised stringent eligibility criteria to approve the cost of DAA for its members. We reviewed the criteria among various Medicaid agencies from States of Ohio and Pennsylvania and noticed similarities and differences among them. The prerequisite process demanding clinical, laboratory, radiologic or histologic documentation is quite cumbersome and sometimes confusing. In certain aspects the eligibility requirements for DAA are not in concordance with the clinical evidence provided by the recently updated guidelines. We have addressed the dilemma most of the providers face while planning HCV treatment for the Medicaid insured patients in regards to the needed testing, clinical documentation and liver fibrosis assessment, along with the clinical implications of such requirements. While HCV remains a major public health issue, variable State Medicaid policies may lead to disparity in access to the emerging DAA with subsequent healthcare outcomes. These gaps may compromise long term efforts of the public health HCV initiatives.

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“…However, it is uncertain whether the severe fibrosis observed in decompensated HCV-LC could be reversed to some extent. Although successful treatment outcomes in HCV induced cirrhotics resulted in the significant prevention of HCC [39] , it is not yet clear whether DAA treatment for decompensated HCV-LC lowers the incidence of HCC. Actually, despite clinical improvement, the occurrence of HCC was not significantly suppressed by NA treatment for decompensated HBV-LC [35] .…”

Section: Expectations and Concerns Of Daa Treatment For Decompensatedmentioning

confidence: 99%

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

Ohkoshi

Hirono

Yamagiwa

2015

WJGPT

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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.

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Eradication of Hepatitis C Virus Infection and the Development of Hepatocellular Carcinoma

Cited by 792 publications

References 65 publications

ABT-450/r–Ombitasvir and Dasabuvir with Ribavirin for Hepatitis C with Cirrhosis

ABT-450/r–Ombitasvir and Dasabuvir with Ribavirin for Hepatitis C with Cirrhosis

The Prescribers’ Dilemma: Treatment of Hepatitis C Infection for Medicaid Insured Patients in United States

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

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