A Healthy Liver After SVR: Food for Thought

Excerpt

Hepatitis C virus (HCV), estimated to affect 71 million people globally [1], is a leading risk factor for the development of cirrhosis and hepatocellular carcinoma (HCC) [2, 3]. With the introduction of direct acting antiviral (DAA) therapies over the past decade, virtually all patients can now be expected to achieve sustained virologic response (SVR), with few side effects when compared with prior interferon (IFN) and ribavirin-based regimens. These agents also reduce the risk of developing HCC [4]. Achieving SVR in patients with HCV, regardless of the therapeutic modality, decreases the risk of liver disease-related complications including bridging fibrosis, HCC, and overall mortality [5]. Even though there are demonstrable outcome benefits associated with the eradication of detectable virus, there are still patients who demonstrate continued chronic inflammation on biopsy and patients who progress to liver disease-related complications. Questions with particular merit would be: what drives this continued disease process? and do patient habits, including substance use patterns and nutritional intake, measurably impact patient outcomes? …