To study the parameters of liver function and portal hypertension in patients with HCV-related decompensated liver cirrhosis after successful direct-acting antivirals therapy.
Material and methods
А prospective study was conducted among 50 patients with HCV-related decompensated liver cirrhosis who achieved sustained virological response after treatment with direct-acting antivirals. Parameters of liver function and portal hypertension, MELD and Сhild–Pugh scores were evaluated before and every 3-6 months after treatment.
During median follow-up of 18 [6-42] months, MELD and Сhild–Pugh scores decreased in 72% and 74% of patients, respectively. Fifty-two percent of patients achieved Сhild–Pugh class A, 89% of patients with baseline Сhild–Pugh class C achieved Сhild–Pugh class B, and 7% of patients worsened to Сhild–Pugh class C. At the end of follow-up, alanine aminotransferase was normal in 90% of patients, whereas the elevated aspartate aminotransferase levels persisted in half of patients. Platelet count increased significantly (р=0.016). Resolution or reduction of ascites occurred in 57% of patients. Male gender (HR 5.19; p = 0.003) and a lower baseline albumin (≤32 g/l, HR 2.97; p = 0.022) were independent risk factors associated with the absence of liver cirrhosis compensation after effective antiviral treatment.
HCV eradication resulted in reduction in MELD and Сhild–Pugh scores in the majority of patients, and compensation of liver cirrhosis in half of them.