Special populations: Treating hepatitis C in patients with decompensated cirrhosis and/or advanced renal impairment


Direct- acting antivirals have revolutionized the treatment of hepatitis C. Sustained virological response rates of at least 95% have become common in the general population. However, along with the ageing of the HCV population, physicians face a growing group of HCV – infected patients with advanced liver and/or renal impairment. The safety and efficacy of treatment remains a clinical challenge in these patients. This review focuses on the current state of knowledge and treatment regimens in patients with decompensated cirrhosis and severe renal impairment. It shows that distinct interferon- free treatments can achieve favourable sustained virological response rates in these difficult- to- treat patients. Moreover, pitfalls and special considerations as well as new emerging challenges in an era of interferon- free regimens will be presented in this article.



decompensated cirrhosis , hepatitis C virus , renal impairment , special populations

About Speaker


Professor of Medicine


City: Frankfurt

Institution: JW Goethe University Hospital

Biography of Stefan ZEUZEM

Professor Zeuzem began his medical training at Goethe-University Medical School, Frankfurt Germany,. He then attended the School of Clinical Medicine at the University of Cambridge and Medical School at the University of Newcastle upon Tyne, finishing in 1985.


He completed research sabbaticals at a number of institutions, including the Howard Hughes Medical Institute, Boyer Center of Molecular Medicine at Yale University Medical School and the Max-Planck-Institute of Biophysics in Frankfurt. From 2002 to 2006 he was a full Professor of Medicine and Chairman of the Department of Internal Medicine II at Saarland University Hospital, Homburg/Saar, Germany.


Professor Zeuzem has co-authored manuscripts, book chapters and reviews encompassing varied aspects of internal medicine. He is a member of numerous professional societies including the German Association for the Study of the Liver (GASL), the European Association for the Study of the Liver (EASL) and the American Association for the Study of Liver Diseases (AASLD). He is a recipient of multiple awards and honors for his research accomplishments.


Professor Zeuzem’s clinical areas of expertise include gastroenterology, hepatology, liver transplantation, endoscopy, gastrointestinal oncology and endocrinology and his current research interests include cellular physiology, molecular biology of hepatitis viruses, viral kinetics, the role of hepatitis C in hepatocarcinogenesis, and the stratification and optimization of antiviral treatment.

View more