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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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