Carmona, ICordero, PAmpuero, JRojas, ARomero-Gómez, M2023-01-252023-01-252016-09-24http://hdl.handle.net/10668/10478Fibrosis progression is common in hepatitis C. Both host and viral factors influence its natural history. Liver fibrosis is a key predictive factor for advanced disease including endpoints such as liver failure, cirrhosis and hepatocellular carcinoma (HCC). METAVIR fibrosis stages F3-F4 have been considered as the threshold for antiviral therapy. However, this aspect is controversial after the advent of new direct-acting antivirals (DAAs) because they show an excellent efficacy and safety profile. Moreover, in the DAA era, fibrosis stage seems not to be a predictive factor of a sustained virological response (SVR). Viral eradication decreases liver damage by improving the inflammation, as well as by regressing fibrosis irrespective of the treatment regimen. Non-invasive methods are useful in the assessment of liver fibrosis, replacing liver biopsy in clinical practice; but their usefulness for monitoring fibrosis after SVR needs to be demonstrated. Fibrosis regression has been demonstrated after the eradication of hepatitis C virus infection and is associated with a lower risk of hepatic cirrhosis and liver cancer. However, patients showing advanced fibrosis and cirrhosis must be followed-up after SVR, as risks of portal hypertension and HCC remain.enDirect-acting antiviralHepatitis CLiver biopsyNon-invasive markersPegylated interferonAntiviral AgentsClinical Trials as TopicDisease ManagementDisease ProgressionHepatitis C, ChronicHumansLiver CirrhosisSustained Virologic Responseresearch article27677698open access10.1016/j.cmi.2016.09.0171469-0691http://www.clinicalmicrobiologyandinfection.com/article/S1198743X16304232/pdf