Abstract

Cirrhosis due to the hepatitis C virus (HCV) is increasing in prevalence and is the leading indication for liver transplantation in the United States. Current FDA-approved treatment for HCV includes peginterferon/ribavirin alone (all HCV genotypes (GT)) or with boceprevir or telaprevir (GT1). Decompensated patients tolerate interferon-based treatment poorly and only ~25 to 40 % with HCV GT1 and ~30 to 50 % with non-1 GTs achieve a sustained viral response. Emerging direct-acting antivirals (DAAs), which are more potent and have less toxicity, used in interferon-free multi-DAA combinations will enhance the tolerability of treatment and should improve outcomes for patients with decompensated cirrhosis.

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