Abstract:
Background: Hepatitis C virus (HCV) infection has a significant worldwide impact. Patients with hepatic cirrhosis with HCV have an annual risk of
decompensation of 3-5%, a risk of developing hepatocellular carcinoma between 1.4-6.9% and a risk of mortality of 2% / year. Therefore, the treatment
of chronic HCV infection is a priority for patients with severe hepatic fibrosis and cirrhosis. The emergence and approval of direct-acting antivirals
(DAA) in recent years have revolutionized antiviral therapy, especially for patients with liver cirrhosis. Following numerous studies it has been found
that, this treatment is well tolerated by these patients. The combination of DAA from different groups has a potent enhancing effect, and the sustained
viral response (SVR) rate reaches up to 85-98% in patients with liver cirrhosis. In general, the chance of performing SVR with DAA in patients with
compensated cirrhosis (Child-Pugh A) is comparable to non-cirrhotic patients. However, there is a risk for decompensation and acute liver failure during
and after treatment. Patients with decompensated liver cirrhosis and advanced liver fibrosis may have greater benefit from antiviral therapy after liver
transplantation.
Conclusions: The data obtained from the analyzed studies suggest that DAA antiviral therapy prevents the progressive evolution of the disease towards
hepatocellular carcinoma or decompensation. At the same time, a correct therapeutic approach and a permanent monitoring of these patients can improve
the quality of life, significantly prolonging the years of life.
Description:
Department of Infectious, Tropical Diseases and Medical Parasitology,
Nicolae Testemitsanu State University of Medicine and Pharmacy, Chișinău, the Republic of Moldova