Role of assessing liver fibrosis in management of chronic hepatitis C virus infection.

Autor:	Carmona I; Inter-Centre Unit of Digestive Diseases and CIBERehd, Virgen del Rocio-Virgen Macarena University Hospitals, Sevilla, Spain., Cordero P; Inter-Centre Unit of Digestive Diseases and CIBERehd, Virgen del Rocio-Virgen Macarena University Hospitals, Sevilla, Spain., Ampuero J; Inter-Centre Unit of Digestive Diseases and CIBERehd, Virgen del Rocio-Virgen Macarena University Hospitals, Sevilla, Spain; Institute of Biomedicine of Seville, Sevilla, Spain., Rojas A; Inter-Centre Unit of Digestive Diseases and CIBERehd, Virgen del Rocio-Virgen Macarena University Hospitals, Sevilla, Spain; Institute of Biomedicine of Seville, Sevilla, Spain., Romero-Gómez M; Inter-Centre Unit of Digestive Diseases and CIBERehd, Virgen del Rocio-Virgen Macarena University Hospitals, Sevilla, Spain; Institute of Biomedicine of Seville, Sevilla, Spain. Electronic address: mromerogomez@us.es.
Jazyk:	angličtina
Zdroj:	Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases [Clin Microbiol Infect] 2016 Oct; Vol. 22 (10), pp. 839-845. Date of Electronic Publication: 2016 Sep 24.
DOI:	10.1016/j.cmi.2016.09.017
Abstrakt:	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. (Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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