Improvement of liver function parameters in advanced HCV-associated liver cirrhosis by IFN-free antiviral therapies

Successful antiviral treatment of decompensated hepatitis B with HBV polymerase inhibitors is associated with improvement of liver function and even de-listing of patients on the transplant waiting list. To what extent liver function also improves in cirrhotic patients with chronic hepatitis C receiving novel IFN-free therapies is unknown. We here analysed 80 consecutive patients with advanced HCV associated liver cirrhosis including 34 patients (43%) with Child B/C cirrhosis and 42 patients (53%) with platelet counts of We show that (i) liver function parameters recover in the majority of patients when HCV replication is successfully blocked irrespectively of the underlying HCV genotype, (ii) that, however, liver disease still can progress in some patients despite achieving a sustained virological response and (iii) that HCV relapse after transient suppression of HCV replication is usually not associated with clinically meaningful worsening of hepatic function even though severe biochemical hepatitis flares can occur in single cases.

In conclusion, this real world single center experience showed that IFN-free treatment of hepatitis C patients with liver cirrhosis restores liver function and possibly reduced the need for liver transplantation in advanced hepatitis C.