BACKGROUND/AIMS: Treatment of chronic hepatitis C infection with direct-acting antiviral (DAA) drugs has been highly effective, but data regarding benefit in advanced liver disease is relatively scarce in Indian patients. The aim of this study was to determine the effects of DAA in patients with HCV related cirrhosis (compensated/decompensated) who achieved sustained virological response post-therapy at 12 weeks (SVR12). METHODS: Sixty-three patients with HCV related cirrhosis treated with sofosbuvir based regimen were evaluated. Data regarding baseline demographics, the severity of liver disease and treatment regimen were collected. The primary end point was to evaluate the effect of treatment (SVR12) on the severity of liver disease with the secondary end point being to observe for any adverse events related to treatment. RESULTS: Treatment naïve patients with HCV cirrhosis either due to genotype 1 or genotype 3 were divided into two groups: group A (compensated cirrhosis), group B (decompensated cirrhosis). SVR12 in group A was 91.66% (33/37) and in group, B was 73.17% (30/41). Baseline mean liver stiffness measurement (LSM) in group A was 16.81 ± 3.57 kPa which decreased to 11.19 ± 1.75 kPa at SVR12 (P-value <0.0001). Baseline mean APRI and FIB-4 score in group A were 1.228 ± 0.499 and 2.61 ± 1.06 and in group B were 2.156 ± 1.10 and 5.71 ± 2.06 respectively which decrease to 0.415 ± 0.115 and 1.25 ± 0.46 in group A, to 0.759 ± 0.275 and 2.60 ± 1.12 in group B following SVR12 (P value <0.0001). Mean MELD-Na improved from baseline 9.93 ± 2.04, 20.70 ± 4.52 to 7.21 ± 0.92, 14.23 ± 4.51 respectively in group A and B at SVR12 (P-value <0.0001). Child-Turcotte-Pugh score improved by 1 in 27.27% (9/33) and ≥2 in 76.67% (23/30) of patients in group A and group B respectively. CONCLUSION: There was a significant improvement in severity of liver disease as depicted by the decrease in LSM and other noninvasive marker of fibrosis in patients who achieved SVR12 on DAA therapy.
BACKGROUND/AIMS: Treatment of chronic hepatitis C infection with direct-acting antiviral (DAA) drugs has been highly effective, but data regarding benefit in advanced liver disease is relatively scarce in Indian patients. The aim of this study was to determine the effects of DAA in patients with HCV related cirrhosis (compensated/decompensated) who achieved sustained virological response post-therapy at 12 weeks (SVR12). METHODS: Sixty-three patients with HCV related cirrhosis treated with sofosbuvir based regimen were evaluated. Data regarding baseline demographics, the severity of liver disease and treatment regimen were collected. The primary end point was to evaluate the effect of treatment (SVR12) on the severity of liver disease with the secondary end point being to observe for any adverse events related to treatment. RESULTS: Treatment naïve patients with HCV cirrhosis either due to genotype 1 or genotype 3 were divided into two groups: group A (compensated cirrhosis), group B (decompensated cirrhosis). SVR12 in group A was 91.66% (33/37) and in group, B was 73.17% (30/41). Baseline mean liver stiffness measurement (LSM) in group A was 16.81 ± 3.57 kPa which decreased to 11.19 ± 1.75 kPa at SVR12 (P-value <0.0001). Baseline mean APRI and FIB-4 score in group A were 1.228 ± 0.499 and 2.61 ± 1.06 and in group B were 2.156 ± 1.10 and 5.71 ± 2.06 respectively which decrease to 0.415 ± 0.115 and 1.25 ± 0.46 in group A, to 0.759 ± 0.275 and 2.60 ± 1.12 in group B following SVR12 (P value <0.0001). Mean MELD-Na improved from baseline 9.93 ± 2.04, 20.70 ± 4.52 to 7.21 ± 0.92, 14.23 ± 4.51 respectively in group A and B at SVR12 (P-value <0.0001). Child-Turcotte-Pugh score improved by 1 in 27.27% (9/33) and ≥2 in 76.67% (23/30) of patients in group A and group B respectively. CONCLUSION: There was a significant improvement in severity of liver disease as depicted by the decrease in LSM and other noninvasive marker of fibrosis in patients who achieved SVR12 on DAA therapy.
Entities:
Keywords:
APRI, AST to Platelet Ratio Index; CTP, Child-Turcotte-Pugh; CTP, Child–Turcotte–Pugh; FIB-4, fibrosis-4; MELD Na, Model for End-Stage Liver Disease sodium; TE, transient elastography
Authors: S Bruno; P M Battezzati; G Bellati; A Manzin; M Maggioni; A Crosignani; M Borzio; L Solforosi; A Morabito; G Ideo; M Podda Journal: J Hepatol Date: 2001-05 Impact factor: 25.083
Authors: Michael Manns; Didier Samuel; Edward J Gane; David Mutimer; Geoff McCaughan; Maria Buti; Martín Prieto; José Luis Calleja; Markus Peck-Radosavljevic; Beat Müllhaupt; Kosh Agarwal; Peter Angus; Eric M Yoshida; Massimo Colombo; Mario Rizzetto; Hadas Dvory-Sobol; Jill Denning; Sarah Arterburn; Phillip S Pang; Diana Brainard; John G McHutchison; Jean-François Dufour; Hans Van Vlierberghe; Bart van Hoek; Xavier Forns Journal: Lancet Infect Dis Date: 2016-02-18 Impact factor: 25.071
Authors: Nezam Afdhal; Stefan Zeuzem; Paul Kwo; Mario Chojkier; Norman Gitlin; Massimo Puoti; Manuel Romero-Gomez; Jean-Pierre Zarski; Kosh Agarwal; Peter Buggisch; Graham R Foster; Norbert Bräu; Maria Buti; Ira M Jacobson; G Mani Subramanian; Xiao Ding; Hongmei Mo; Jenny C Yang; Phillip S Pang; William T Symonds; John G McHutchison; Andrew J Muir; Alessandra Mangia; Patrick Marcellin Journal: N Engl J Med Date: 2014-04-11 Impact factor: 91.245
Authors: Judith A Aberg; Joel E Gallant; Khalil G Ghanem; Patricia Emmanuel; Barry S Zingman; Michael A Horberg Journal: Clin Infect Dis Date: 2014-01 Impact factor: 9.079
Authors: Adriaan J van der Meer; Bart J Veldt; Jordan J Feld; Heiner Wedemeyer; Jean-François Dufour; Frank Lammert; Andres Duarte-Rojo; E Jenny Heathcote; Michael P Manns; Lorenz Kuske; Stefan Zeuzem; W Peter Hofmann; Robert J de Knegt; Bettina E Hansen; Harry L A Janssen Journal: JAMA Date: 2012-12-26 Impact factor: 56.272
Authors: C Bureau; S Metivier; J M Peron; J Selves; M A Robic; P A Gourraud; O Rouquet; E Dupuis; L Alric; J P Vinel Journal: Aliment Pharmacol Ther Date: 2008-04-04 Impact factor: 8.171
Authors: Jack X Q Pang; Scott Zimmer; Sophia Niu; Pam Crotty; Jenna Tracey; Faruq Pradhan; Abdel Aziz M Shaheen; Carla S Coffin; Steven J Heitman; Gilaad G Kaplan; Mark G Swain; Robert P Myers Journal: PLoS One Date: 2014-04-22 Impact factor: 3.240
Authors: Nezam Afdhal; K Rajender Reddy; David R Nelson; Eric Lawitz; Stuart C Gordon; Eugene Schiff; Ronald Nahass; Reem Ghalib; Norman Gitlin; Robert Herring; Jacob Lalezari; Ziad H Younes; Paul J Pockros; Adrian M Di Bisceglie; Sanjeev Arora; G Mani Subramanian; Yanni Zhu; Hadas Dvory-Sobol; Jenny C Yang; Phillip S Pang; William T Symonds; John G McHutchison; Andrew J Muir; Mark Sulkowski; Paul Kwo Journal: N Engl J Med Date: 2014-04-11 Impact factor: 91.245
Authors: Graham R Foster; William L Irving; Michelle C M Cheung; Alex J Walker; Benjamin E Hudson; Suman Verma; John McLauchlan; David J Mutimer; Ashley Brown; William T H Gelson; Douglas C MacDonald; Kosh Agarwal Journal: J Hepatol Date: 2016-01-30 Impact factor: 30.083