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June 20, 2022World Journal of HepatologyOpen Access

Impact of direct-acting antiviral regimens on hepatic and extrahepatic manifestations of hepatitis C virus infection

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Authors

ISIman Ibrahim SalamaHRHala M. RaslanSSSomaia I Salama

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Overview

Narrative review demonstrates widespread clinical benefits of direct-acting antivirals across hepatic and extrahepatic hepatitis C conditions, highlighting the value of early intervention.

Key Points

  • To review direct-acting antiviral treatments for hepatitis C virus infection and assess their prognostic impact on liver disease and extrahepatic complications.
  • Synthesized clinical findings on pan-genotypic direct-acting antiviral regimens across major hepatitis C virus genotypes.
  • Assessed predictors of treatment failure, viral resistance mutations, post-clearance liver cancer risks, and extrahepatic therapeutic responses.
  • Pan-genotypic direct-acting antivirals achieve a sustained virological response exceeding 85% at 12 weeks, though efficacy declines with older age, cirrhosis, or baseline resistance-associated substitutions (such as A30K, Y93H, and P53del in genotype 3).
  • Observed rates of hepatocellular carcinoma post-therapy likely reflect baseline advanced cirrhosis, subclinical tumors, or altered immune surveillance, alongside a risk of hepatitis B virus reactivation in co-infected individuals.
  • Treatment resolves extrahepatic manifestations, yielding improvements in insulin resistance in 90% of patients, reducing cardiovascular events, increasing glomerular filtration rate, and alleviating mixed cryoglobulinemia.

Cite This Study

Salama et al. (2022) studied this question.

synapsesocial.com/papers/6a93d443cd4df3c00e006a19https://doi.org/10.4254/wjh.v14.i6.1053
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