Khullar Vikas, Firpi Roberto J
Vikas Khullar, Roberto J Firpi, Department of Medicine, University of Florida College of Medicine, Gainesville, FL 32608, United States.
World J Hepatol. 2015 Jul 18;7(14):1843-55. doi: 10.4254/wjh.v7.i14.1843.
Chronic hepatitis C infection is the leading cause of chronic liver disease, cirrhosis, hepatocellular carcinoma as well as the primary indication for liver transplantation in the United States. Despite recent advances in drugs for the treatment of hepatitis C, predictive models estimate the incidence of cirrhosis due to hepatitis C infection will to continue to rise for the next two decades. There is currently an immense interest in the treatment of patients with fibrosis and early-stage cirrhosis as treatment can lead to decrease in the rates of decompensated cirrhosis, hepatocellular carcinoma and need for liver transplantation in these patients. The goal of this paper is to provide clinicians and health care professionals further information about the treatment of patients with hepatitis C infection and cirrhosis. Additionally, the paper focuses on the disease burden, epidemiology, diagnosis and the disease course from infection to treatment. We provide an overview of multiple studies for the treatment of chronic hepatitis C infection that have included patients with cirrhosis. We also discuss the advantages and disadvantages of treatment in cirrhotic patients and focus on the most up to date guidelines available for treatment.
慢性丙型肝炎感染是美国慢性肝病、肝硬化、肝细胞癌的主要病因，也是肝移植的主要指征。尽管近期丙型肝炎治疗药物取得了进展，但预测模型估计，未来二十年丙型肝炎感染所致肝硬化的发病率仍将持续上升。目前，对于纤维化和早期肝硬化患者的治疗备受关注，因为治疗可降低这些患者失代偿性肝硬化、肝细胞癌的发生率以及肝移植需求。本文旨在为临床医生和医护人员提供有关丙型肝炎感染合并肝硬化患者治疗的更多信息。此外，本文重点关注疾病负担、流行病学、诊断以及从感染到治疗的疾病进程。我们概述了多项针对慢性丙型肝炎感染治疗且纳入了肝硬化患者的研究。我们还讨论了肝硬化患者治疗的利弊，并重点关注最新的治疗指南。
