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

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Open Journal of Gastroenterology 2024年第6期14卷 203-212页

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

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).

关键词： Post-Viral Cirrhosis C Pegylated Interferon Direct Acting Antivirals Sustained Viral Response child score Fibrosis

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child-Pugh-Turcott versus Meld score for predicting survival in a retrospective cohort of black African cirrhotic patients

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World Journal of Gastroenterology 2008年第2期14卷 286-291页

作者： KA Attia KC Ackoundou-N'guessan AT N’dri-yoman AK Mahassadi E Messou YF Bathaix YH Kissi Service of Hepatology Gastroenterology and Generalmedicine Yopougon Teaching Hospital Abidjan Ivory Coast Service of Nephrology Dialysis andHypertension Yopougon Teaching Hospital Abidjan Ivory Coast Centre for the Management Research and Training onHIV/AIDS infection and related diseases (CEPREF-ACONDAVS) Yopougon-Attié Abidjan Ivory Coast

AIM: To compare the performance of the child-Pugh-Turcott (CPT) score to that of the model for end-stage liver disease (MELD) score in predicting survival of a retrospective cohort of 172 Black African patients with cirrhosis on a short and mid-term ***: Univariate and multivariate (Cox model) analyses were used to identify factors related to mortality. Relationship between the two scores was appreciated by calculating the correlation coefficient. The Kaplan Meier method and the log rank test were used to elaborate and compare survival respectively. The Areas Under the Curves were used to compare the performance between scores at 3, 6 and 12 ***: The study population comprised 172 patients, of which 68.9% were male. The mean age of the patient was 47.5 ± 13 years. Hepatitis B virus infection was the cause of cirrhosis in 70% of the cases. The overall mortality was 31.4% over 11 years of follow up. Independent factors significantly associated with mortality were: CPT score (HR = 3.3, 95% CI [1.7-6.2]) (P 1.5 mg/dL versus serum creatine score (HR = 2.9, 95% CI [1.63-5.21]) (P 21 vs MELD score and the MELD ***: The CPT score displays the sameprognostic significance as does the MELD score in black African patients with cirrhosis. Moreover, its handling appears less cumbersome in clinical practice as compared to the latter.

关键词： Model for end-stage liver disease score child score Cirrhosis Black African Survival

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Six-minute walking test performance is associated with survival in cirrhotic patients

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World Journal of Hepatology 2021年第11期13卷 1791-1801页

作者： Carolina Frade M G Pimentel Ana Cristina de Castro Amaral Adriano Miziara Gonzalez Michelle Lai Danielde Oliveira Mota Maria Lucia Gomes Ferraz Wilson Mathias Junior Mario Kondo Department of Medicine Federal University of Sao PauloSao Paulo 04026090Brazil Department of Gastroenterology Federal University of Sao PauloSao Paulo 04023062Brazil Department of Surgery Liver Transplantation ServiceFederal University of Sao PauloSao Paulo 04026090Brazil Department of Medicine Division of Gastroenterology and HepatologyBeth Israel Deaconess Medical CenterBostonMA 02215United States Department of Industrial Engineering University of Sao PauloSao Paulo 05508010Brazil Department of Cardiology Heart InstituteUniversity of Sao PauloSao Paulo 05403900Brazil

BACKGROUND Patients with cirrhosis are at risk of cirrhotic cardiomyopathy,with resulting cardiac dysfunction and exercise *** minute walking test(6MWT)assesses functional status and predicts morbidity and mortality in cardiopulmonary *** To determine if it associates with mortality by analyzing 6MWT performance in patients with liver *** A cohort of 106 cirrhotic patients was evaluated in the outpatient setting with echocardiogram and 6MWT and follow up for one year to document hepatic decompensation and *** distance in meters was recorded at the end of 6 min(6MWD).RESULTS This cohort had a mean age of 51 years and 56%male;patients were staged as child A in 21.7%,B 66%and C 12.3%.Walk distance inversely correlated with child scores,and was significantly reduced as child stages *** who died(10.4%)showed shorter mean 6MWD(P=0.006).Low 6MWD was an independent predictor of mortality(P=0.01).CONCLUSION 6MWT is a noninvasive inexpensive test whose result is related to child scores and *** is useful to identify patients with liver cirrhosis at high risk of mortality for closer monitoring and potential early intervention.

关键词： Six-minute walking test Liver cirrhosis Hospital admission and mortality child score

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