HCV Treatment in Decompensated Disease

This article will review the treatment of hepatitis C virus (HCV) with direct-acting antiviral agents in special populations. Patients with decompensated cirrhosis are physiologically distinct from those without cirrhosis or with compensated cirrhosis and require additional treatment considerations. Additional discussion will center on other unique populations for HCV treatment, including those with end-stage renal disease, HIV, or hepatitis B virus coinfection, and hepatocellular carcinoma.Recent FindingsPatients with decompensated cirrhosis are ineligible for certain direct-acting antiviral agents due to the risk of further decompensation and death. This population is also nuanced, as liver transplantation must also be considered, and pretransplant HCV treatment may have unintended downstream transplantation considerations. It is recommended that patients with decompensated cirrhosis undergo HCV treatment in conjunction with a liver transplant center.SummaryThe direct-acting antiviral agents are highly effective and well tolerated and have greatly simplified the treatment of HCV. However, patients such as those with decompensated cirrhosis, viral coinfection, end-stage renal disease, and hepatocellular carcinoma are more complex and require additional considerations for treatment.
Source: Current Hepatitis Reports - Category: Infectious Diseases Source Type: research