Liver Fibrosis in the Post-HCV Era

摘要

The introduction of interferon-free regimens for the treatment of chronic hepatitis C virus (HCV) infection represents a key turn in hepatology because of their extremely high therapeutic efficacy and relatively safe use also in "difficult-to-treat" and/or "difficult-to-cure" HCV subgroups, including patients with cirrhosis. Due to treatment guidelines based on health economics, patients with cirrhosis will likely represent the frontline in the use of the new anti-HCV agents. Accordingly, this article concentrates on the effect of sustained viral response (SVR) following antiviral treatment for HCV on the evolution of tissue fibrosis and cirrhosis, and more importantly, on the clinical consequences of viral eradication, particularly in patients in which SVR has been achieved in an advanced stage of the disease. In this context, the assessment of fibrosis regression and possibly of cirrhosis reversal will represent the diagnostic challenge of the next decade.