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Doctors need to have “full and frank” discussions with patients about the potential risks and benefits of using direct-acting antivirals (DAAs) to treat hepatitis C in late-stage liver disease, especially among those waiting for a liver transplant, liver specialists said at the 2016 International Liver Congress in Barcelona on Thursday.
Direct-acting antiviral treatment may not eliminate the need for a liver transplant or significantly prolong life in cases where a transplant is not available.
Experts were commenting on a large Spanish study of people with advanced liver disease who have received DAAs since 2013.
Although DAAs have produced high cure rates in people with hepatitis C who have advanced fibrosis and cirrhosis, there is still caution regarding their use in people with decompensated cirrhosis who are candidates for liver transplant. Use of ribavirin alongside DAAs in these patients is considered risky, and the extent to which DAAs can improve liver function in advanced liver disease in people awaiting a liver transplant is unclear.