[Treatment of cirrhosis caused by hepatitis C].
There are real concerns about patients with cirrhosis after HCV infection and their outcome because the survival rate after 5 years in the group with descompensated liver disease (Child-Pugh C) is very poor, it's only 50%. Likewise, it's possible that these patients develop another feared complication, hepatocellular carcinoma. This tumor can appear even in patients with compensated cirrhosis. Prevalence varies according to the geographic region. In the occidental countries, prevalence is 7-11% in the 5 year follow-up (1.6-3.2 cases for every 100 persons each year). On the other hand, oriental series report a prevalence of 30% in the 5 year follow-up (6-7 cases for every 100 persons each year). The quality of available information leads us to suggest that therapy with pegylated interferon and ribavirin is clearly indicated for patients with compensated cirrhosis as long as the white cell and platelet counts allow the reduction induced by the therapy. This scheme is contraindicated in cirrhotic patients with a Child-Pugh score of 10 points or more. Available data about therapeutic effect on cirrhosis progression suggest that an effective scheme based on interferon is able to induce a sustained viral response, and is related with a lesser risk of complications secondary to liver failure. The survival rate is better in these patients. Clinical observations suggest that interferon may prevent hepatocellular carcinoma in cirrhotic patients after HCV infection, especially in Oriental countries which have a high incidence of this carcinoma. Because of geographical and racial differences between East and West, it's inadequate to extrapolate information from one of these regions to the other.
Bosques Padilla
Francisco
F
Subdirección de Postgrado, Ave. Madero y Gonzalitos S/N, Col. Mitras, 64460 Monterrey, N.L. fbosques58@hotmail.com
D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology; D018450:Disease Progression; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000209:etiology*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors
Tratamiento del paciente cirrótico por hepatitis C.