title: Concise review: Interferon-free treatment of hepatitis C virus-associated cirrhosis and liver graft infection.
abstract: Chronic hepatitis C is a major reason for development of cirrhosis and hepatocellular carcinoma and a leading cause for liver transplantation. The development of direct-acting antiviral agents lead to (pegylated) interferon-alfa free antiviral therapy regimens with a remarkable increase in sustained virologic response (SVR) rates and opened therapeutic options for patients with advanced cirrhosis and liver graft recipients. This concise review gives an overview about most current prospective trials and cohort analyses for treatment of patients with liver cirrhosis and liver graft recipients. In patients with compensated cirrhosis Child-Pugh-Turcotte (CTP) class A, all approved agents are safe and SVR rates do not significantly differ from patients without cirrhosis in general. In patients with decompensated cirrhosis CTP class B or C, daclastasvir, ledipasvir, velpatasvir, and sofosbuvir are approved, and SVR rates higher than 90% can be achieved. Especially for patients with a model of end stage liver disease score higher than 15 and therefore eligible for liver transplantation, data is scarce. Reported SVR rates in patients with cirrhosis CTP class C are lower compared to patients with a less severe liver disease. In liver transplant recipients with a maximum of CTP class A, SVR rates are comparable to patients without LT. Patients with decompensated graft cirrhosis should be treated on an individual basis.
authors.affiliation: Nina Weiler, Stefan Zeuzem, Martin-Walter Welker, Universitätsklinikum Frankfurt, Medizinische Klinik 1, 60590 Frankfurt, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Weiler
authors.affiliation: Nina Weiler, Stefan Zeuzem, Martin-Walter Welker, Universitätsklinikum Frankfurt, Medizinische Klinik 1, 60590 Frankfurt, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
authors.affiliation: Nina Weiler, Stefan Zeuzem, Martin-Walter Welker, Universitätsklinikum Frankfurt, Medizinische Klinik 1, 60590 Frankfurt, Germany.
authors.forename: Martin-Walter
authors.initials: MW
authors.lastname: Welker
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004347:Drug Interactions; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000601:surgery* / Q000821:virology; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects*; D018579:Patient Selection; D012008:Recurrence; D012307:Risk Factors; D000072230:Sustained Virologic Response; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents
keywords: Cirrhosis; Direct antiviral agents; Hepatitis C; Interferon-free antiviral treatment; Liver transplantation