Interferon‐free regimens for chronic hepatitis C overcome the effects of portal hypertension on virological responses

Mandorfer, Mattias; Kozbial, K; Freissmuth, C; Schwabl, Philipp; Stättermayer, Albert Friedrich; Reiberger, Thomas; Beinhardt, Sandra; Schwarzer, R; Trauner, Michael; Ferlitsch, Arnulf; Hofer, Harald; Peck‐Radosavljevic, Markus; Ferenci, Péter

doi:10.1111/apt.13315

Cited by 51 publications

(33 citation statements)

References 46 publications

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“…Eight patients (24%) had a >20% fall in HVPG, in 4 of whom it dropped to a value of <12 mm Hg. 63 Mandorfer et al 69 studied 56 patients with cirrhosis in whom HVPG was measured before starting treatment with SOF with RBV or DCV or SMV (simeprevir) for 12-24 weeks. Forty-one (73%) of these patients had a baseline HVPG >10 mm Hg.…”

Section: Decompensated Cirrhosismentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Decompensated Cirrhosismentioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…In our study involving 80 patients with advanced liver cirrhosis, we described an overall improvement of parameters associated with liver synthesis in the far majority of patients already during therapy while platelet counts showed different (delayed) kinetics of improvement. 2 Together with the preliminary findings by Karlas et al, and the Austrian experience recently present in this journal, 3 we would propose that future studies need to address the following issues:(i) what is relative contribution of inflammation vs. fibrotic scarving to portal hypertension? (ii) what will be the longterm kinetics of liver function parameters and liver stiffness values after HCV clearance?…”

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confidence: 83%

Letter: can persisting liver stiffness indicate increased risk of hepatocellular cell carcinoma after successful anti-HCV therapy? - authors’ reply

Deterding

Schlevogt

Port

et al. 2016

Aliment Pharmacol Ther

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“…The study showed that 24% of these patients had a fall in HVPG to the extent exceeding 20%, and in half of them the HVPG had dropped to a value of <12 mmHg. The second study 60 enrolled 56 patients with cirrhosis in whom HVPG was measured before starting treatment with SOF + RBV or DCV and simeprevir (SMV) for 12-24 weeks. Majority (73%) of these patients had a baseline HVPG >10 mm of Hg.…”

Section: Improvement In Portal Hypertensionmentioning

confidence: 99%

Potential Liver Transplant Recipients with Hepatitis C: Should They Be Treated Before or After Transplantation?

Anand

2017

Journal of Clinical and Experimental Hepatology

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Interferon‐free regimens for chronic hepatitis C overcome the effects of portal hypertension on virological responses

Abstract: SUMMARY BackgroundPortal hypertension is the strongest predictor of virological response to pegylated interferon (IFN)/ribavirin in patients with chronic hepatitis C (CHC)-related cirrhosis.

Cited by 51 publications

References 46 publications

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Letter: can persisting liver stiffness indicate increased risk of hepatocellular cell carcinoma after successful anti-HCV therapy? - authors’ reply

Potential Liver Transplant Recipients with Hepatitis C: Should They Be Treated Before or After Transplantation?

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