Unraveling the Impact of Direct-Acting Antivirals on Hepatitis-Linked Cirrhosis: A Comprehensive Analysis of Fibrosis, Child Score, and Disease Progression

作     者：Hajar Cherkaoui Maryam Elkhayari Maria Lahlali Asmae Lamine Nada Lahmidani Amine Mekkaoui Mounia Elyousfi Dafr Allah Benajah Mohammed El Abkari Adil Ibrahimi Hakima Abid Hajar Cherkaoui;Maryam Elkhayari;Maria Lahlali;Asmae Lamine;Nada Lahmidani;Amine Mekkaoui;Mounia Elyousfi;Dafr Allah Benajah;Mohammed El Abkari;Adil Ibrahimi;Hakima Abid

作者机构：Department of Hepato-Gastroenterology Hassan II University Hospital Fez Morocco Faculty of Medicine and Pharmacy of Fez USMBA Fez Morocco 

出 版 物：《Open Journal of Gastroenterology》 (肠胃病学期刊（英文）)

年 卷 期：2024年第14卷第6期

页      面：203-212页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Post-Viral Cirrhosis C Pegylated Interferon Direct Acting Antivirals Sustained Viral Response Child Score Fibrosis 

摘      要：The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).