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Treatment of chronic HCV infection in compensated and decompensated cirrhosis
Author(s) -
BAHR MATTHIAS J,
MANNS MICHAEL P
Publication year - 2004
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2004.03652.x
Subject(s) - medicine , cirrhosis , hepatocellular carcinoma , decompensation , gastroenterology , liver disease , liver transplantation , hepatitis c , hepatitis c virus , liver function , cytopenia , transplantation , immunology , virus , bone marrow
Abstract Currently, we are faced with an increasing number of patients with HCV‐induced end‐stage liver disease. Per year, up to 4% of the patients with compensated cirrhosis develop complications subsequently leading to a substantial decrease in survival. Decompensated liver cirrhosis due to hepatitis C is the leading indication for liver transplantation (OLT). However, reinfection of the graft is common with an accelerated course of the disease in many patients. Depending on the disease stage, the aims of antiviral therapy may differ between patients with HCV‐induced liver cirrhosis. Antiviral therapy can reverse the extent of fibrosis. Even without viral clearance, the incidence of hepatocellular carcinoma is lowered by interferon. In naïve patients with compensated HCV‐induced cirrhosis, sustained virological responses can be achieved in up to 50% of the cases. Retreatment of non‐responders may clear the virus in about 10% of the patients. Though elimination of HCV prior to OLT is certainly desirable, treatment is often limited by severe cytopenia and decompensation of liver function. Of the eligible patients 20% sustain viral clearance after OLT.