1Gastroenterology/Hepatology Division, Liver Transplantation, Indiana University Health, Indiana University School of Medicine, 975 West Walnut, IB 327, Indianapolis, IN 46202-5121, USA. Electronic address: firstname.lastname@example.org.
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.