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Title: Role of assessing liver fibrosis in management of chronic hepatitis C virus infection.
Authors: Carmona, I
Cordero, P
Ampuero, J
Rojas, A
Romero-Gómez, M
Keywords: Direct-acting antiviral;Hepatitis C;Liver biopsy;Non-invasive markers;Pegylated interferon
metadata.dc.subject.mesh: Antiviral Agents
Clinical Trials as Topic
Disease Management
Disease Progression
Hepatitis C, Chronic
Liver Cirrhosis
Sustained Virologic Response
Issue Date: 24-Sep-2016
Abstract: Fibrosis progression is common in hepatitis C. Both host and viral factors influence its natural history. Liver fibrosis is a key predictive factor for advanced disease including endpoints such as liver failure, cirrhosis and hepatocellular carcinoma (HCC). METAVIR fibrosis stages F3-F4 have been considered as the threshold for antiviral therapy. However, this aspect is controversial after the advent of new direct-acting antivirals (DAAs) because they show an excellent efficacy and safety profile. Moreover, in the DAA era, fibrosis stage seems not to be a predictive factor of a sustained virological response (SVR). Viral eradication decreases liver damage by improving the inflammation, as well as by regressing fibrosis irrespective of the treatment regimen. Non-invasive methods are useful in the assessment of liver fibrosis, replacing liver biopsy in clinical practice; but their usefulness for monitoring fibrosis after SVR needs to be demonstrated. Fibrosis regression has been demonstrated after the eradication of hepatitis C virus infection and is associated with a lower risk of hepatic cirrhosis and liver cancer. However, patients showing advanced fibrosis and cirrhosis must be followed-up after SVR, as risks of portal hypertension and HCC remain.
metadata.dc.identifier.doi: 10.1016/j.cmi.2016.09.017
Appears in Collections:Producción 2020

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