Follow-up post-HCV virological response to DAA in advanced chronic liver disease

Liver Int. 2024 Dec;44(12):3138-3150. doi: 10.1111/liv.16113. Epub 2024 Sep 30.

Abstract

Direct-acting antivirals (DAA) achieve high virological response rates with minimal side effects for many patients. Despite their significant impact on the progression and epidemiology of hepatitis C virus (HCV) associated liver disease, the global annual incidence of chronic infections is expected to remain relatively constant, averaging 1.42 million new cases each year until 2030. Furthermore, by 2030, there will be a 14-17% increase in end-stage liver disease outcomes such as liver-related deaths, hepatocellular carcinoma (HCC), and decompensated cirrhosis in adults aged 18 years and over. Although reductions in liver decompensation, HCC occurrence, and mortality have been shown in patients with advanced liver disease who achieved sustained virological response (SVR) with DAA, these benefits may be less significant in those with decompensated liver cirrhosis. This review aims to summarise the impact of the virological response to DAA on liver disease progression and outcomes in patients with advanced chronic liver disease, which appears to be crucial for defining patient-specific follow-up.

Keywords: advanced chronic liver disease; chronic hepatitis C; sustained virological response.

Publication types

  • Review

MeSH terms

  • Antiviral Agents* / therapeutic use
  • Carcinoma, Hepatocellular* / drug therapy
  • Carcinoma, Hepatocellular* / virology
  • Disease Progression*
  • Hepacivirus* / drug effects
  • Hepatitis C, Chronic* / complications
  • Hepatitis C, Chronic* / drug therapy
  • Humans
  • Liver Cirrhosis* / drug therapy
  • Liver Cirrhosis* / virology
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / virology
  • Sustained Virologic Response*

Substances

  • Antiviral Agents