Progress of antiviral therapy for hepatitis C virus-related decompensated cirrhosis
10.3760/cma.j.issn.1007-3418.2019.12.003
- VernacularTitle: 丙型肝炎肝硬化失代偿期抗病毒治疗进展
- Author:
Yuemin NAN
1
;
Lingdi LIU
;
Wen ZHAO
;
Luyao CUI
Author Information
1. Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang 050051, China
- Publication Type:Journal Article
- Keywords:
Hepatitis C virus;
Liver cirrhosis;
Decompensation of liver function;
Directed-acting antiviral agents
- From:
Chinese Journal of Hepatology
2019;27(12):919-922
- CountryChina
- Language:Chinese
-
Abstract:
Direct-acting antiviral agents (DAAs) are the main antiviral therapeutics for hepatitis C virus-related decompensated stage cirrhosis. DAAs of NS3/4A protease inhibitors use is not recommended for patients with decompensated cirrhosis due to characteristics of DAAs metabolism in liver. The recent guidelines have recommended sofosbuvir (SOF)-based plan including pan-genotype plan of sofosbuvir(SOF)/velpatasvir (VEL), sofosbuvir combined with daclatasvir (DCV), genotype 1,4,5,6 specific plan of sofosbuvir (SOF) / ledipasvir (LDV) for 24 weeks or above in combination with ribavirin for 12 weeks because NS5B and NS5A inhibitors has no obvious effect on CYP450 enzyme system and achievement of sustained virological response (SVR) rates at 12/24 weeks is achievable in 88% ~ 100%, and liver reserve function improves in 42% ~ 53% of patients. Furthermore, approximately 15.5% ~ 49% of patients waiting for liver transplantation after treatment with DAAs do not require liver transplantation for short-term and 10.3% ~19.2% of patients receiving SOF/LDV, and SOF combined with DCV not needed liver transplantation. Thus, the clinical application of DAAs provides a safe and reliable antiviral treatment plan for hepatitis C virus-related decompensated stage cirrhosis.
