bms-790052 and Esophageal-and-Gastric-Varices

Medical treatment of decompensated cirrhosis due to hepatitis C virus (HCV) remains a clinical challenge even in the era of direct-acting antiviral drugs (DAAs). We evaluated the efficacy and safety of DAAs in the management of HCV genotype 4-related decompensated cirrhosis.. The study included a treatment group (n = 160) composed of HCV patients with decompensated cirrhosis who received DAAs for 3 months and a matched control group (n = 80) who preferred not to receive DAAs, follow-up was for 24-31 months.. In treatment group; there were improvements in platelet count, albumin, CTP (p = 0.001) and MELD scores (p = 0.03), a significant reduction in the frequency of hepatic encephalopathy (HE). SVR was achieved in 90%. Hepatocellular carcinoma (HCC) developed in 10% (n = 18) within 6.8 ± 2.5 months after DAAs, survival was higher in the treated vs. the control group (28.9 ± 0.95 vs. 11.4 ± 2.2 months, p = 0.001). Liver volume by ultrasound at a cutoff 495 ml was predictive of complications after DAAs therapy mainly HCC and reduced survival with sensitivity 93.2%, specificity 72%.. HCV with decompensated cirrhosis and adequate liver volume had a 90% SVR with improved CTP&MELD and survival.. (NCT03547895).

Topics: Adult; Antiviral Agents; Ascites; Carbamates; Drug Therapy, Combination; Esophageal and Gastric Varices; Female; Hepatic Encephalopathy; Hepatitis C, Chronic; Humans; Imidazoles; Liver Cirrhosis; Male; Middle Aged; Patient Selection; Pyrrolidines; Quality of Life; Ribavirin; RNA, Viral; Severity of Illness Index; Sofosbuvir; Survival Rate; Sustained Virologic Response; Ultrasonography; Valine