Interferon-free treatment for HCV-infected patients with decompensated cirrhosis.
Progress in interferon-free treatment against hepatitis C virus (HCV) has remained a challenge in patients with decompensated cirrhosis due to a paucity of information on efficacy and safety profiles. This review illustrates that interferon-free treatment could result in greater than 85 % sustained virological response (SVR) rates in patients with HCV genotype 1 and decompensated cirrhosis. The combination of pangenotypic HCV NS5A inhibitor velpatasvir and HCV NS5B inhibitor sofosbuvir has demonstrated high SVR rates in patients with HCV genotypes 1, 2, 3, 4 or 6 and decompensated cirrhosis. Certain patients discontinued treatment due to adverse events, death or having liver transplantation. Taken together, interferon-free treatment could produce higher SVR rates in decompensated hepatic cirrhosis. However, as adverse events were occasionally observed, liver transplantation should always be considered as well. Further improvements in treatment are called for in patients with decompensated cirrhosis.
Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 220-8677, Japan. kandat-cib@umin.ac.jp.
Tatsuo
T
Kanda
D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002219:Carbamates / Q000008:administration & dosage* / Q000009:adverse effects; D002986:Clinical Trials as Topic; D004338:Drug Combinations; D016174:Hepacivirus / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006576:Heterocyclic Compounds, 4 or More Rings / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000821:virology; D064887:Observational Studies as Topic; D011446:Prospective Studies; D000069474:Sofosbuvir / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D000998:Antiviral Agents; D002219:Carbamates; D004338:Drug Combinations; D006576:Heterocyclic Compounds, 4 or More Rings; C000611331:sofosbuvir-velpatasvir drug combination; D000069474:Sofosbuvir
Decompensated cirrhosis; NS5A inhibitors; Nucleotide analogue NS5B inhibitor; SVR