Improvement of liver function parameters in advanced HCV‐associated liver cirrhosis by IFN‐free antiviral therapies

Summary Background Successful antiviral treatment of decompensated hepatitis B with HBV polymerase inhibitors is associated with improvement of liver function. To what extent liver function also improves in cirrhotic patients with chronic hepatitis C receiving novel interferon‐free (IFN‐free) therap...

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Bibliographic Details
Published in:	Alimentary pharmacology & therapeutics Vol. 42; no. 7; pp. 889 - 901
Main Authors:	Deterding, K., Höner zu Siederdissen, C., Port, K., Solbach, P., Sollik, L., Kirschner, J., Mix, C., Cornberg, J., Worzala, D., Mix, H., Manns, M. P., Cornberg, M., Wedemeyer, H.
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-10-2015
Subjects:	Adult Aged Antiviral agents Antiviral Agents - administration & dosage Antiviral Agents - therapeutic use Bilirubin Cholinesterase Cirrhosis Cohort Studies Drug Therapy, Combination Female Genotypes Hepatitis Hepatitis B Hepatitis C Hepatitis C, Chronic - diagnostic imaging Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - pathology Hepatitis C, Chronic - physiopathology Humans Imidazoles - therapeutic use Interferon Kinetics Liver Liver - diagnostic imaging Liver - drug effects Liver - pathology Liver - physiopathology Liver cirrhosis Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - drug therapy Liver Cirrhosis - pathology Liver Cirrhosis - physiopathology Liver Cirrhosis - virology Liver Function Tests Liver transplantation Male Middle Aged Patients Prothrombin Ribavirin Ribavirin - therapeutic use Ribonucleic acid RNA Simeprevir - therapeutic use Sofosbuvir - therapeutic use Treatment Outcome Ultrasonography Uridine Monophosphate - therapeutic use
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Summary:	Summary Background Successful antiviral treatment of decompensated hepatitis B with HBV polymerase inhibitors is associated with improvement of liver function. To what extent liver function also improves in cirrhotic patients with chronic hepatitis C receiving novel interferon‐free (IFN‐free) therapies is unknown. Aim To study liver function in cirrhotic HCV patients receiving IFN‐free therapies. Methods We here studied 80 consecutive patients with advanced HCV associated liver cirrhosis including 34 patients (43%) with Child B/C cirrhosis and 42 patients (53%) with platelet counts of <90.000/μL receiving different combinations of direct acting antivirals without interferon [sofosbuvir/ribavirin (n = 56), sofosbuvir/simeprevir ± ribavirin (n = 15) and sofosbuvir/daclatasvir ± ribavirin (n = 9)]. The majority of patients was infected with HCV genotype 1 (n = 50); HCV genotypes 2, 3 and 4 were present in 4, 24 and 2 patients, respectively. Results Liver function parameters including albumin, bilirubin, cholinesterase and prothrombin time all improved in the majority of patients during antiviral therapy irrespectively of the underlying HCV genotype, however, with different kinetics. MELD scores improved until post‐treatment week 12 in 44% of the patients but worsened in 15%. A sustained virological response was achieved in 63% of the patients. HCV RNA relapse led to moderate ALT increases in 15/23 patients but was not associated with hepatic decompensations. Conclusion This real‐world single centre study showed that interferon‐free treatment of hepatitis C patients with advanced liver cirrhosis restores liver function, and may thereby reduce the need for liver transplantations.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0269-2813 1365-2036
DOI:	10.1111/apt.13343