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Virologic Cure of Hepatitis C: Impact on Hepatic Fibrosis and Patient Outcomes

  • Liver (S Cotler and E Kallwitz, Section Editors)
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Abstract

Treatment with direct-acting antiviral agents has revolutionized the approach to hepatitis C. We are now able to obtain high sustained virological response (SVR) rates, even in the historically difficult-to-treat patient populations. SVR translates into improved clinical outcomes, particularly overall and liver-related mortality, and benefits are more striking in patients with cirrhosis. A 2.5- to 5-fold risk reduction in the incidence of hepatocellular carcinoma and improvement in complications derived from portal hypertension have been reported as well. It is hypothesized that the benefits from SVR occur largely due to regression of fibrosis, which arises from the halt on the fibrogenic stimuli and activation of extracellular matrix reabsorption signals. Non-invasive markers of fibrosis are being utilized to assess regression, but it is still unclear how accurate they are in this clinical scenario. Interventions aiming to improve liver wellness and screening for cirrhosis-related complications should continue to be the norm after SVR.

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Acknowledgments

The authors would like to thank Dr. M. Katherine Rude for her critical review of the manuscript and Dr. Laura W. Lamps for contributing to our figure. This work is partially supported by the University of Arkansas for Medical Sciences College of Medicine Clinician Scientist Program.

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Authors and Affiliations

  1. Department of Transplant Surgery/Center of Advanced Liver Disease, Methodist University Hospital, University of Tennessee Health Science Center, 1211 Union Ave., Suite 340, Memphis, TN, 38104, USA

    Humberto C. Gonzalez

  2. Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, 4301 W. Markham, #567, Little Rock, AR, 72205, USA

    Andrés Duarte-Rojo

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Correspondence to Andrés Duarte-Rojo.

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HCG declares that he has no conflicts of interest. ADR reports grants from Vital Therapies and personal fees from Gilead Sciences, outside the submitted work.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and were in compliance with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Liver

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Gonzalez, H.C., Duarte-Rojo, A. Virologic Cure of Hepatitis C: Impact on Hepatic Fibrosis and Patient Outcomes. Curr Gastroenterol Rep 18, 32 (2016). https://doi.org/10.1007/s11894-016-0508-y

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