Effect of direct-acting antiviral drugs on portal circulation hemodynamics in cirrhotic patients infected with HCV

• Published in: Egyptian Liver Journal Vol. 12; no. 1; pp. 1 - 6
• Main Authors: Hassnine, Alshymaa A, Soliman, Wail, Elsayed, Amr M, Higazi, Mahmoud M, Saied, Mery, Abdelraheem, Ehab M
• Format: Journal Article
• Language: English
• Published: Springer 22-02-2022; SpringerOpen
• Subjects: Antiviral agents; Blood; Chronic HCV; Direct antiviral agents (DAAS); Doppler and duplex examination; Drug therapy; Hepatitis B; Hepatitis C; Hepatitis C virus; Hypertension; Liver; Liver cirrhosis; Medical examination; Medical research; Medical screening; Medicine, Experimental; Portal hypertension; Egypt
• ISSN: 2090-6218; 2090-6226
• DOI: 10.1186/s43066-022-00181-4

Background Liver cirrhosis (LC) is the most common cause of portal hypertension. In chronic hepatitis C patients who are treated with direct-acting antiviral therapy (DAAS), the progression of cirrhosis can be reversed with treatment. Portal hypertension is also expected to improve with a virological response. Aim To evaluate the effect of direct-acting antiviral therapy on portal circulation hemodynamics in cirrhotic patients infected with HCV. Methods This study included 78 consecutive patients with chronic HCV-related liver disease. They were treated by a sofosbuvir-based regimen in combination with daclatasavir. All patients were subjected to routine investigations (complete blood count, liver and renal function tests), hepatitis B surface antigen, [alpha] feto protein, PCR of HCV RNA, imaging (abdominal ultrasound and colored Doppler and duplex examination for the assessment portal hypertension) before starting treatment and after 1 year. Results There was a significant improvement in Doppler parameters such as portal vein (PV) diameter, PV velocity, PV cross-sectional area, portal congestive index, splenic vein diameter, and spleen span; the decrease in portal pressure occur in about 55% of the patients; several factors are associated with non-response as a history of bilharziasis, patients from a rural area, presence of splenomegaly and varices, low HB level, low platelet count, and high level of fibrosis. Conclusion Sustained virological response to direct-acting antiviral therapy is associated with a reduction in portal pressure in patients with liver cirrhosis and clinically significant portal hypertension.