title: Special populations: treating hepatitis C in patients with decompensated cirrhosis and/or advanced renal impairment.
abstract: Direct-acting antivirals have revolutionized the treatment of hepatitis C. Sustained virological response rates of at least 95% have become common in the general population. However, along with the ageing of the HCV population, physicians face a growing group of HCV-infected patients with advanced liver and/or renal impairment. The safety and efficacy of treatment remains a clinical challenge in these patients. This review focuses on the current state of knowledge and treatment regimens in patients with decompensated cirrhosis and severe renal impairment. It shows that distinct interferon-free treatments can achieve favourable sustained virological response rates in these difficult-to-treat patients. Moreover, pitfalls and special considerations as well as new emerging challenges in an era of interferon-free regimens will be presented in this article.
authors.affiliation: Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt a.M., Germany.
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Mücke
authors.affiliation: Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt a.M., Germany.
authors.forename: Victoria T
authors.initials: VT
authors.lastname: Mücke
authors.affiliation: Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt a.M., Germany.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Lange
authors.affiliation: Department of Internal Medicine 1, University Hospital Frankfurt, Frankfurt a.M., Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications* / Q000821:virology; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000150:complications* / Q000821:virology; D012254:Ribavirin / Q000627:therapeutic use; D000069474:Sofosbuvir / Q000627:therapeutic use; D000072230:Sustained Virologic Response
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin; D000069474:Sofosbuvir
keywords: decompensated cirrhosis; hepatitis C virus; renal impairment; special populations