Vascular Changes in Chronic Hepatitis C Cirrhotic Patients Treated with Direct Acting Antiviral Agents

Abstract

Egypt has high prevalence of HCV infection. Portal hypertension is a leading cause of morbidity and mortality in patients with liver cirrhosis. Aim of our study evaluating changes of portal circulation by upper GIT endoscopy and gray scale abdominal ultrasound before and after 12 weeks treatment. Methods Our study is a observational prospective of 150 HCV cirrhotic patients receiving different DAA regimens. Results showed normalizations of Fibrosis-4 (FIB-4) score among patients after treatment which was statistically significant (p-value <0.001) while, ultrasound Measurements of PV, SMV, SV and Spleen diameter done before and after treatment, follow up period of 6 months with p-value (0.821 0.988, 0.841 ,0.923) respectively, and endoscopic follow up with progression esophageal varices size occurred in 3.7%, new varices incidance occurred in 2.3%, progression of red color signs occurred in 1.9% and 5.4% of patients had an attack of GIT bleeding with varices incidence between naïve and experienced patients (p-value0.395), PHG incidence, before and after treatment (p-value 0.780), without significant difference. Conclusion HCV treatment improve liver enzymes in cirrhotic patients; however viral eradication did not always mean cure of liver cirrhotic patients on follow up with no statistically significant difference on portal hypertension changes