Future of liver disease in the era of direct acting antivirals for the treatment of hepatitis C
Open Access
- 1 January 2017
- journal article
- review article
- Published by Baishideng Publishing Group Inc. in World Journal of Hepatology
- Vol. 9 (7), 352-367
- https://doi.org/10.4254/wjh.v9.i7.352
Abstract
Hepatitis C virus (HCV) infection has been a global health problem for decades, due to the high number of infected people and to the lack of effective and well-tolerated therapies. In the last 3 years, the approval of new direct acting antivirals characterized by high rates of virological clearance and excellent tolerability has dramatically improved HCV infection curability, especially for patients with advanced liver disease and for liver transplant recipients. Long-term data about the impact of the new direct acting antivirals on liver fibrosis and liver disease-related outcomes are not yet available, due to their recent introduction. However, previously published data deriving from the use of pegylated-interferon and ribavirin lead to hypothesizing that we are going to observe, in the future, a reduction in mortality and in the incidence of hepatocellular carcinoma, as well as a regression of fibrosis for people previously affected by hepatitis C. In the liver transplant setting, clinical improvement has already been described after treatment with the new direct acting antivirals, which has often led to patients delisting. In the future, this may hopefully reduce the gap between liver organ request and availability, probably expanding liver transplant indications to other clinical conditions. Therefore, these new drugs are going to change the natural history of HCV-related liver disease and the epidemiology of HCV infection worldwide. However, the global consequences will depend on treatment accessibility and on the number of countries that could afford the use of the new direct acting antivirals.Keywords
This publication has 109 references indexed in Scilit:
- Safety and efficacy of adjuvant pegylated interferon therapy for metastatic tumor antigen 1-positive hepatocellular carcinomaCancer, 2013
- Effect of type 2 diabetes on risk for malignancies includes hepatocellular carcinoma in chronic hepatitis CHepatology, 2012
- Long‐term cohort study of chronic hepatitis C according to interferon efficacyJournal of Gastroenterology and Hepatology, 2011
- Boceprevir for Previously Treated Chronic HCV Genotype 1 InfectionThe New England Journal of Medicine, 2011
- Management of hepatocellular carcinoma: An updateHepatology, 2011
- Clinical, virologic, histologic, and biochemical outcomes after successful HCV therapy: A 5-year follow-up of 150 patientsHepatology, 2008
- Peginterferon alfa-2b and ribavirin in patients with hepatitis C virus and decompensated cirrhosis: A controlled studyJournal of Hepatology, 2007
- Prevention of hepatocellular carcinoma recurrence with alpha-interferon after liver resection in HCV cirrhosisHepatology, 2006
- Changing disease burden of hepatocellular carcinoma in the Far East and Southeast AsiaLiver International, 2005
- Global Burden of Disease (GBD) for Hepatitis CThe Journal of Clinical Pharmacology, 2004