Management of Cirrhotic Patients After Successful HCV Eradication
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Chronic hepatitis C (HCV) is a hepatotropic virus which, when untreated, can lead to progressive inflammation and fibrosis resulting in cirrhosis, hepatocellular carcinoma (HCC), and decompensations related to end-stage liver disease. The relatively recent introduction of all oral, interferon-free, direct-acting antiviral medications against HCV has transformed the management of these patients. Previous treatment regimens were prolonged, poorly tolerated, and frequently did not result in cure. Current therapies achieve sustained viral response (SVR) in the vast majority of patients including those with decompensated liver disease; a previously challenging population to treat. These successes will result in significant numbers of cirrhotic patients requiring management after SVR. Although many complications of cirrhosis are improved in this setting, regular follow-up of HCC, esophageal varices, and other sequelae of cirrhosis will be necessary. This chapter will review the management of cirrhosis in HCV patients achieving cure.
KeywordsHepatitis C Cirrhosis Decompensated liver disease Gastroesophageal varices Ascites Hepatic encephalopathy Hepatocellular carcinoma Sustained virologic response Portal hypertension
Compliance with Ethical Standards
Conflict of Interest
Ryan M. Kwok declares no conflict of interest.
Tram T. Tran declares grants and personal fees from Gilead Sciences, BMS, AbbVie, Merck, and Janssen.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance
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