title: Follow-up of patients with chronic hepatitis C and a sustained viral response.
abstract: Patients with chronic hepatitis C who achieve a sustained virological response (SVR) after antiviral treatment have improved survival and liver-related morbidity compared to non-SVR patients. However, long-term follow-up studies in SVR patients have shown that the regression of fibrosis varies and the risk of liver-related complications remains, even in the absence of cirrhosis. While patients with cirrhosis are still at risk of hepatocellular carcinoma, comorbidities such as diabetes, obesity or alcohol consumption may play a major role in the outcome of liver disease in SVR patients without cirrhosis. The risk of re-infection is high in patients with a persistent risk of contamination such as IV drug users or men who have sex with men. Thus, in the era of highly efficient DAAs regimens, monitoring after a cure of HCV infection remains a major challenge in SVR patients. This review describes long-term HCV infection and liver-related outcomes in SVR patients, as well as the profile of patients who are still at risk of progression, and monitoring techniques including non-invasive markers for the assessment of fibrosis.
authors.affiliation: AP-HP, Service d'Hépatologie, Hôpital Saint-Antoine, F75012, Paris, France.|UPMC Univ Paris 6, UMR_S938, F75012, Paris, France.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Serfaty
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D015897:Comorbidity; D018450:Disease Progression; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000821:virology; D008113:Liver Neoplasms / Q000473:pathology; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012367:RNA, Viral / Q000235:genetics; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D016898:Interferon-alpha; D012367:RNA, Viral; D011092:Polyethylene Glycols; D012254:Ribavirin
keywords: NAFLD; fibrosis; hepatocellular carcinoma; non-invasive markers