The first-line option in the treatment of patients with advanced fibrosis and cirrhosis due to genotype 1 hepatitis C virus is currently triple therapy with boceprevir/telaprevir and pegylated interferon-ribavirin. However, certain limitations could constitute a barrier to starting treatment or achieving sustained viral response in these patients. These limitations include the patient's or physician's perception of treatment effectiveness in routine clinical practice-which can weight against the decision to start treatment-, the advanced stage of the disease with portal hypertension and comorbidity, treatment interruption due to poor adherence, and adverse effects, mainly anemia. In addition, it is now possible to identify patients who could benefit from a shorter therapeutic regimen with a similar cure rate. This review discusses these issues and their possible effect on the use of triple therapy.
Keywords: Boceprevir; Cirrhosis; Cirrosis; Clinical practice; Hepatitis C virus; Interferón pegilado; Pegylated interferon; Práctica clínica; Recomendaciones; Recommendations; Ribavirin; Ribavirina; Telaprevir; Tratamiento; Treatment; Virus de la hepatitis C.
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