Geum-Youn Gwak

doi:10.4166/kjg.2016.67.3.137

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Gwak: Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? – Treatment of Patients with Decompensated Cirrhosis

Review Article

Korean J Gastroenterol 2016;67(3):137-141.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.67.3.137

Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? – Treatment of Patients with Decompensated Cirrhosis

Geum-Youn Gwak

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence to: Geum-Youn Gwak, Department of Medicine, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: +82-2-3410-3409, Fax: +82-2-3410-6983, E-mail: gy.gwak@samsung.com

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

HCV-related decompensated liver cirrhosis is a life-threatening illness with an average 5-year survival rate of 50%. Because these patients have higher risk of morbidity and mortality including development of hepatocellular carcinoma, the benefits of eradicating the virus may be greater than in those with less-advanced disease. Recently, direct-acting antiviral agents (DAAs) are replacing interferon-based regimens that have serious adverse events and low tolerability in the treatment of HCV infection. Many clinical trials using combination of several DAAs with or without ribavirin are now actively ongoing in HCV-related decompensated cirrhosis, and encouraging data are beginning to appear. In this review, recent advances in the treatment of HCV-related decompensated cirrhosis are introduced with special focus on new DAAs.

Keywords: Hepatitis C virus, Decompensated liver cirrhosis, Direct-acting antiviral agents

References

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Table 1.

Clinical Studies Using Direct-acting Antiviral Agents in HCV-related Decompensated Cirrhosis Patients

Study	Drug	Genotype	CTP class	n	SVR12	Reference
SOLAR-2	Ledipasivir/sofosbuvir, ribavirin	1, 4	B, C	108	B: 12 wk (87%), 24 wk (89%)	8
					C: 12 wk (86%), 24 wk (87%)
ALLY-1	Daclatasvir, sofosbuvir, ribavirin	1, 2, 3, 4, 6	A, B, C	60	Overall: 83%	9
					Genotype 1: A (91%), B (92%), C (50%)
	Simeprevir, sofosbuvir, ±ribavirin	1	A, B, C	156	A (91%), B/C (73%)	10
	Sofosbuvir, ribavirin	1, 2, 3, 4	A, B	61	Posttransplantation: 70%	15

CTP, Child-Pugh-Turcotte; SVR, sustained virological response.

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