skip to main content

DAA in Decompensated Cirrhosis — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHepatitisDAA in Decompensated CirrhosisSCE Infectious Diseases

A 60-year-old woman with known HCV cirrhosis develops hepatorenal syndrome. She has not been treated for HCV. Should HCV treatment with DAAs be offered?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Yes — DAA therapy may stabilise or improve liver function even in decompensated cirrhosis; Sofosbuvir/Velpatasvir ± Ribavirin can be used in Child-Pugh B/C (avoid protease inhibitor-containing regimens)

Explanation lettering: D = shown as A · A = shown as B · E = shown as D · B = shown as E

HCV treatment should be offered to patients with decompensated cirrhosis (Child-Pugh B/C) using NS5A inhibitor-based regimens WITHOUT protease inhibitors (which are hepatotoxic in decompensation). Sofosbuvir/Velpatasvir ± Ribavirin is the standard approach. SVR can stabilise liver function, improve MELD scores, and potentially avoid or delay liver transplant. Some patients improve sufficiently to be delisted from the transplant waiting list. Treatment should be initiated by experienced hepatologists in centres managing decompensated liver disease.

Reference: EASL 2024 – HCV in decompensated cirrhosis; NICE TA499/507