BACKGROUND: Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child-Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child-Pugh B cirrhosis. METHODS: We conducted a prospective multicentre study among patients with Child-Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs. RESULTS: Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (p < 0.001). Liver parameters significantly improved from baseline to 12 weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1 month of treatment were significantly associated with a decompensated cirrhosis at the last observation. CONCLUSIONS: Treatment with DAA in patients with Child-Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.
BACKGROUND: Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child-Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child-Pugh B cirrhosis. METHODS: We conducted a prospective multicentre study among patients with Child-Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs. RESULTS: Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (p < 0.001). Liver parameters significantly improved from baseline to 12 weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1 month of treatment were significantly associated with a decompensated cirrhosis at the last observation. CONCLUSIONS: Treatment with DAA in patients with Child-Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.
Entities:
Keywords:
Decompensated cirrhosis; Direct-acting antivirals; Hepatitis C virus
Authors: Diego Rincon; Cristina Ripoll; Oreste Lo Iacono; Magdalena Salcedo; Maria V Catalina; Emilio Alvarez; Oscar Nuñez; Ana M Matilla; Gerardo Clemente; Rafael Bañares Journal: Am J Gastroenterol Date: 2006-10 Impact factor: 10.864
Authors: Virginia Hernández-Gea; Carles Aracil; Alan Colomo; Isabel Garupera; Maria Poca; Xavier Torras; Josep Miñana; Carlos Guarner; Càndid Villanueva Journal: Am J Gastroenterol Date: 2012-02-14 Impact factor: 10.864
Authors: Pietro Andreone; Massimo G Colombo; Jeffrey V Enejosa; Iftihar Koksal; Peter Ferenci; Andreas Maieron; Beat Müllhaupt; Yves Horsmans; Ola Weiland; Henk W Reesink; Lino Rodrigues; Yiran B Hu; Thomas Podsadecki; Barry Bernstein Journal: Gastroenterology Date: 2014-05-09 Impact factor: 22.682
Authors: Stuart Roberts; Adam Gordon; Catriona McLean; John Pedersen; Scott Bowden; Kenneth Thomson; Peter Angus Journal: Clin Gastroenterol Hepatol Date: 2007-06-04 Impact factor: 11.382
Authors: David R Nelson; James N Cooper; Jacob P Lalezari; Eric Lawitz; Paul J Pockros; Norman Gitlin; Bradley F Freilich; Ziad H Younes; William Harlan; Reem Ghalib; Godson Oguchi; Paul J Thuluvath; Grisell Ortiz-Lasanta; Mordechai Rabinovitz; David Bernstein; Michael Bennett; Trevor Hawkins; Natarajan Ravendhran; Aasim M Sheikh; Peter Varunok; Kris V Kowdley; Delphine Hennicken; Fiona McPhee; Khurram Rana; Eric A Hughes Journal: Hepatology Date: 2015-03-10 Impact factor: 17.425
Authors: Fred Poordad; Eugene R Schiff; John M Vierling; Charles Landis; Robert J Fontana; Rong Yang; Fiona McPhee; Eric A Hughes; Stephanie Noviello; Eugene S Swenson Journal: Hepatology Date: 2016-03-07 Impact factor: 17.425
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
Authors: Ekram W Abd El-Wahab; Waleed M Abd Elgawad; Mohamed S Abdelaziz; Ashraf I Mikheal; Hanan Z Shatat Journal: Am J Trop Med Hyg Date: 2022-02-28 Impact factor: 3.707
Authors: Mariana Sandoval Lourenço; Patricia Momoyo Y Zitelli; Marlone Cunha-Silva; Arthur Ivan N Oliveira; Roque Gabriel Rezende de Lima; Evandro de Oliveira Souza; Claudia P Oliveira; Tiago Sevá-Pereira; Flair J Carrilho; Mario G Pessoa; Daniel F Mazo Journal: Clinics (Sao Paulo) Date: 2021-11-19 Impact factor: 2.365