Therapy for hepatitis C has entered the era of all-oral direct-acting antiviral agents. Sustained response rates are now greater than 90% for all genotypes, although patients with cirrhosis remain the most difficult to treat. There are limited data for patients with cirrhosis and with hepatitis C genotypes 4 and 6 with cirrhosis. Genotype 3 patients with cirrhosis need additional strategies to achieve the sustained virologic response rates seen in genotype 1 patients with cirrhosis. This article outlines the currently available therapies for patients with cirrhosis and hepatitis C across all genotypes, with suggested management strategies.
Keywords: Cirrhosis; Direct-acting antivirals; Hepatitis C; Ledipasvir; Ombitasvir; Paritaprevir; Simeprevir; Sofosbuvir.
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