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Berge et al. Hepatoma Res 2017;3:209-14 Hepatoma Research
DOI: 10.20517/2394-5079.2017.28
www.hrjournal.net
Original Article Open Access

Clinical outcomes of direct-acting antiviral

therapy in patients with compensated

hepatitis C virus-related cirrhosis

Estefania Berge, Ana Arencibia, Elena Otón, Luis Cejas, Silvia Acosta, Francisco Pérez

Liver Unit, Hospital Universitario Nuestra Señora de la Candelaria, 38010 Santa Cruz de Tenerife, Spain.

Correspondence to: Dr. Estefanía Berge, Liver Unit, Hospital Universitario Nuestra Señora de la Candelaria, Carretera General del Rosario, 145, 38010
Santa Cruz de Tenerife, Spain. E-mail: estefania.berge@gmail.com
How to cite this article: Berge E, Arencibia A, Otón E, Cejas L, Acosta S, Pérez F. Clinical outcomes of direct acting antiviral therapy in patients
with compensated hepatitis C virus-related cirrhosis. Hepatoma Res 2017;3:209-14.
ABSTRACT

Article history: Aim: The aim was to assess the clinical impact of direct-acting antiviral treatment in
Received: 25 Jun 2017 patients with compensated hepatitis C virus-related cirrhosis after one year of follow-up.
Accepted: 12 Sep 2017 Methods: An observational retrospective study was conducted on 129 consecutive patients
with compensated cirrhosis treated in 2015, analyzing the evolution of liver function and
Published: 27 Sep 2017
the development of hepatocellular carcinoma and clinical decompensations. Results: The
Key words: median follow-up time was 16 months. Most patients were males (73%), the mean age was
Direct-acting antiviral therapy, 58.1 years and the most frequent genotype was 1b (52.2%). All participants were Child-Pugh
compensated cirrhosis, A class at the start of the treatment and the median model for end-stage liver disease (MELD)
score was 7. Four patients (4.4%) suffered a decompensation: three episodes of ascites and one
hepatocellular carcinoma, acute on chronic liver failure. The incidence of de novo hepatocellular carcinoma during the
clinical decompensation
follow-up was 3.6%. Seven patients (7.8%) improved MELD score more than one point and
in 11 patients (12.2%) it worsened more than one point. There was a significant improvement
in the mean platelets count [P < 0.001, 95% confidence interval (CI): -26,360, -12,096] and
in the mean albumin levels (P < 0.001, 95% CI: -322, -130) after treatment. Conclusion:
Direct-acting antiviral treatment is not associated in the short term with a decrease in the
development of hepatic decompensation or hepatocellular carcinoma compared to what it
was reported for untreated compensated cirrhotic patients. There is an improvement in pre
and post-treatment platelet counts and albumin levels showing a probable improvement of
the hepatic function.

INTRODUCTION to several factors such as age, alcohol consumption
or hepatitis B or human immunodeficiency virus (HIV)
Chronic hepatitis C virus (HCV) infection affects co-infection . Once cirrhosis is established, a yearly
[3]
around 160 million people worldwide . Around 16% incidence of hepatocellular carcinoma of 1.4-3.4% [4-6] ,
[1]
of patients will develop cirrhosis after 20 years of and a yearly incidence of hepatic decompensation
infection , although fibrosis progression can vary due (including episodes of ascites, jaundice, hepatic
[2]
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