ABT-450/r-ombitasvir and dasabuvir with ribavirin eliminates viraemia in most patients with HCV infection with cirrhosis.

Context The prevalence of hepatitis C virus (HCV) reached its peak in 1994 and is expected to decrease significantly over the next few years. However, HCV-related cirrhosis continues to increase. Razavi et al predicted that decompensated cirrhosis will reach its peak in 2019. This translates into increased healthcare costs secondary to complications of cirrhosis. Patients with cirrhosis due to HCV infection are less likely to achieve a sustained virological response (SVR), even in the era of direct-acting antivirals (DAA). Only 62% of genotype-3 cirrhotics treated with sofosbuvir and ribavirin for 24 weeks achieved SVR compared with 87% of non-cirrhotics. Treatment of advanced cirrhosis brings increased risks of complications. As fewer cirrhotics are generally included in interferon-free trials, expected outcomes are extrapolated from a small number of participants. Poordad and colleagues explored rates of SVR and adverse events associated with ABT-450/r-ombitasvir, dasabuvir and ribavirin among a cohort of exclusively patients with cirrhosis.