Impact of sustained virologic response on short-term clinical outcomes in hepatitis C-related cirrhosis. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Bashir, Muhammad H.; Fazili, Javid; Madhoun, Mohammad F.; Kanagala, Rajesh; Chen, Sixia; Nusrat, Salman
• Is Part Of: European journal of gastroenterology & hepatology. Volume 30:Issue 3(2018:Mar.)
• Publication Date: 2018-03
• Subjects: compensated cirrhosis -- decompensated cirrhosis -- hepatitis C -- portal hypertension; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000001032
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Background: Hepatitis C virus (HCV) is a common cause of cirrhosis, leading to increased morbidity and mortality. Treatment of the underlying etiology has been shown to improve fibrosis and cirrhosis. Aim: We sought to evaluate the impact of a sustained virologic response on liver chemistries, model for end stage liver disease (MELD) score, Child–Pugh–Turcotte score (CPT), and fibrosis 4 score (FIB4) in patients with liver cirrhosis secondary to HCV with portal hypertension, with or without decompensation. Methods: Patients with HCV seen in our transplant clinic between June 2013 and September 2015 were identified using ICD-9 code 573.3. Charts were reviewed retrospectively. Results: We collected data from 92 patients with a mean pretreatment MELD score of 9.16±2.98. The most common genotype was Ia, n =79 (86%). The mean duration of follow-up was 7.52±2.25 months. Transaminitis improved significantly at follow-up versus pretreatment [mean aspartate transaminase from 81.2±62.9 to 32.4±12.0 ( P <0.0001); alanine transaminase 74.7±77.8 to 27.7±19.4 ( P <0.0001)]. Albumin, bilirubin, and α-fetoprotein improved significantly. MELD scores improved in patients with pretreatment scores greater than 10 ( P <0.0003), but not in patients with pretreatment scores less than 10 ( P =0.501). The CPT score decreased from 6.1±0.9 to 5.8±0.9 ( P <0.0024). The FIB4 score improved significantly in patients with baseline FIB4 more than 3.24, but not with higher baseline FIB4. Conclusion: Use of direct antivirals in patients with decompensated cirrhosis because of HCV leads to improved MELD, FIB4, and CPT scores.