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Interferon-free treatment for HCV-infected patients with decompensated cirrhosis

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Abstract

Progress in interferon-free treatment against hepatitis C virus (HCV) has remained a challenge in patients with decompensated cirrhosis due to a paucity of information on efficacy and safety profiles. This review illustrates that interferon-free treatment could result in greater than 85 % sustained virological response (SVR) rates in patients with HCV genotype 1 and decompensated cirrhosis. The combination of pangenotypic HCV NS5A inhibitor velpatasvir and HCV NS5B inhibitor sofosbuvir has demonstrated high SVR rates in patients with HCV genotypes 1, 2, 3, 4 or 6 and decompensated cirrhosis. Certain patients discontinued treatment due to adverse events, death or having liver transplantation. Taken together, interferon-free treatment could produce higher SVR rates in decompensated hepatic cirrhosis. However, as adverse events were occasionally observed, liver transplantation should always be considered as well. Further improvements in treatment are called for in patients with decompensated cirrhosis.

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Acknowledgments

The author thanks Prof. Osamu Yokosuka for valuable discussion. Presented in part: ASIAN PACIFIC ASSOCIATION FOR STUDY OF THE LIVER SINGLE THEME CONFERENCE, HCV Infection and Disease & Recent Advances in Liver Diseases, New Delhi, India, 19 December 2016.

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Authors and Affiliations

  1. Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 220-8677, Japan

    Tatsuo Kanda

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Correspondence to Tatsuo Kanda.

Ethics declarations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study. This article does not contain any studies with animal subjects.

Conflict of interest

Tatsuo Kanda received lecture fees from Chugai Pharmaceutical, MSD, Tanabe-Mitsubishi, Daiichi-Sankyo, Bristol-Myers Squibb, Gilead Sciences and Abbvie, and a research grant from Chugai and MSD.

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Kanda, T. Interferon-free treatment for HCV-infected patients with decompensated cirrhosis. Hepatol Int 11, 38–44 (2017). https://doi.org/10.1007/s12072-016-9749-y

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