title: [Triple therapy in cirrhotic patients and those with advanced fibrosis: relevant aspects in clinical practice].
abstract: The first-line option in the treatment of patients with advanced fibrosis and cirrhosis due to genotype 1 hepatitis C virus is currently triple therapy with boceprevir/telaprevir and pegylated interferon-ribavirin. However, certain limitations could constitute a barrier to starting treatment or achieving sustained viral response in these patients. These limitations include the patient's or physician's perception of treatment effectiveness in routine clinical practice-which can weight against the decision to start treatment-, the advanced stage of the disease with portal hypertension and comorbidity, treatment interruption due to poor adherence, and adverse effects, mainly anemia. In addition, it is now possible to identify patients who could benefit from a shorter therapeutic regimen with a similar cure rate. This review discusses these issues and their possible effect on the use of triple therapy.
authors.affiliation: Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, CIBERehd, Universidad de Alcalá, Madrid, España.
authors.forename: Agustín
authors.initials: A
authors.lastname: Albillos
authors.affiliation: Servicio de Aparato Digestivo, Unidad de Hepatología, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: José
authors.initials: J
authors.lastname: Luis Calleja
authors.affiliation: Hospital Clínico, Xerencia de Xestión Integrada de Santiago de Compostela, Santiago de Compostela, España.
authors.forename: Esther
authors.initials: E
authors.lastname: Molina
authors.affiliation: Unidad Hepatología, CIBERehd, Servicio de Aparato Digestivo, Hospital Germans Trias i Pujol, Badalona (Barcelona), España.
authors.forename: Ramon
authors.initials: R
authors.lastname: Planas
authors.affiliation: Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Romero-Gómez
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Turnes
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Tenerife, España. Electronic address: mhernandezguerra@gmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Hernández-Guerra
mesh_terms: D000740:Anemia / Q000139:chemically induced; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology; D055118:Medication Adherence; D024821:Metabolic Syndrome / Q000453:epidemiology; D009842:Oligopeptides / Q000009:adverse effects / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011392:Proline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011480:Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D009842:Oligopeptides; D011480:Protease Inhibitors; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline
keywords: Boceprevir; Cirrhosis; Cirrosis; Clinical practice; Hepatitis C virus; Interferón pegilado; Pegylated interferon; Práctica clínica; Recomendaciones; Recommendations; Ribavirin; Ribavirina; Telaprevir; Tratamiento; Treatment; Virus de la hepatitis C