Special populations: treating hepatitis C in patients with decompensated cirrhosis and/or advanced renal impairment

Direct‐acting antivirals have revolutionized the treatment of hepatitis C. Sustained virological response rates of at least 95% have become common in the general population. However, along with the ageing of the HCV population, physicians face a growing group of HCV‐infected patients with advanced l...

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Bibliographic Details
Published inLiver international Vol. 37; no. S1; pp. 19 - 25
Main Authors Mücke, Marcus M., Mücke, Victoria T., Lange, Christian M., Zeuzem, Stefan
Format Journal Article
LanguageEnglish
Published United States Wiley Subscription Services, Inc 01.01.2017
Subjects
Antiviral agents
Antiviral Agents - therapeutic use
Cirrhosis
decompensated cirrhosis
Drug Therapy, Combination
Hepacivirus
Hepatitis
Hepatitis C
hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - drug therapy
Humans
Impairment
Interferon
Interferon-alpha - therapeutic use
Kidneys
Liver
Liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - virology
Medical personnel
Patients
Physicians
Randomized Controlled Trials as Topic
Renal function
renal impairment
Renal Insufficiency - complications
Renal Insufficiency - virology
Response rates
Ribavirin - therapeutic use
Sofosbuvir - therapeutic use
special populations
Sustained Virologic Response
hepatitis C virus
decompensated cirrhosis
special populations
renal impairment
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Summary:Direct‐acting antivirals have revolutionized the treatment of hepatitis C. Sustained virological response rates of at least 95% have become common in the general population. However, along with the ageing of the HCV population, physicians face a growing group of HCV‐infected patients with advanced liver and/or renal impairment. The safety and efficacy of treatment remains a clinical challenge in these patients. This review focuses on the current state of knowledge and treatment regimens in patients with decompensated cirrhosis and severe renal impairment. It shows that distinct interferon‐free treatments can achieve favourable sustained virological response rates in these difficult‐to‐treat patients. Moreover, pitfalls and special considerations as well as new emerging challenges in an era of interferon‐free regimens will be presented in this article.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
content type line 23
ObjectType-Review-1
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.13279