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Direct antiviral agents in hepatitis C virus related liver disease:Don’t count the chickens before they’re hatched

World Journal of Gastroenterology 2021年第21期27卷 2771-2783页

作者： stella compagnoni Erica Maria Bruno Giorgio Madonia Marco Cannizzaro Salvatore Madonia Department of Internal Medicine V.Cervello HospitalUniversity of PalermoPalermo 90146Italy Department of Surgical Oncological and Oral SciencesSection of Medical OncologyUniversity of PalermoPalermo 90127Italy Department of Emergency Medicine A.Ajello HospitalTrapani 91026Italy Department of Internal Medicine V.Cervello HospitalPalermo 90146Italy

Since molecules with direct-acting antiviral(DAA)became available,the landscape of the treatment of hepatitis C virus(HCV)infection has completely *** new drugs are extremely effective in eradicating infection,and treatment is very well tolerated with a duration of 8-12 *** review aims to report the outstanding clinical benefits of DAA and to highlight their critical disadvantages,identifying some clinically relevant hot ***,do the rates of virological response remain as high when patients with more advanced cirrhosis are considered?Large studies have shown slightly lower but still satisfactory rates of response in these ***,modified schedules with an extended treatment duration and use of ribavirin may be ***,does the treatment of HCV infection affect the risk of occurrence and recurrence of liver cancer?Incidence is reduced after viral eradication but remains high enough to warrant periodic surveillance for an early *** contrast,the risk of recurrence seems to be unaffected by viral clearance;however,DAA treatment improves survival because of the reduced risk of progression of liver ***,can HCV treatment also have favorable effects on major comorbidities?HCV eradication is associated with a reduced incidence of diabetes,an improvement in glycemic control and a decreased risk of cardiovascular events;nevertheless,a risk of hypoglycemia during DAA treatment has been ***,is it safe to treat patients with HCV/hepatitis B virus(HBV)coinfection?In this setting,HCV is usually the main driver of viral activity,while HBV replication is *** various studies have described HBV reactivation after HCV clearance,a baseline evaluation for HBV coinfection and a specific follow-up is mandatory.

关键词： Hepatitis C virus Direct antiviral activity Advanced cirrhosis Liver cancer Diabetes mellitus Hepatitis C virus/hepatitis B virus coinfection

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