Abstract

Purpose: This study aimed to investigate whether patients with hepatitis C virus (HCV)-related cirrhosis and clinically significant portal hypertension (CSPH) could show satisfactory virological and safety outcomes on direct-acting antiviral (DAA) therapy. Methods: Patients with HCV-related cirrhosis treated with DAA therapy were collected in the period between December 2014 and December 2015. Patient characteristics, therapeutic details, and safety outcomes were evaluated. CSPH was defined as presence of gastroesophageal varices via esophagogastroduodenoscopy. Results: Totally, 113 patients were included in this study; 26 with CSPH and 87 without CSPH. HCV genotype 1b-infected patients were treated with either daclatasvir plus asunaprevir or sofosbuvir plus ledipasvir. HCV genotype 2-infected patients were treated with sofosbuvir plus ribavirin. Sustained virological response (SVR) rates were equally good in patients with CSPH (96%) and in those without CSPH (93%). In patients who achieved SVR, prompt improvements in the hepatic function were observed. Recovery was more pronounced in patients with CSPH. There was no early treatment discontinuation and no hepatic decompensation. Conclusions: DAA therapy in patients with HCV-related cirrhosis and CSPH could achieve a high SVR rate and early improvements in the hepatic function. This treatment strategy showed relatively fair safety outcomes.

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