- HCV treatment with direct-acting antivirals (DAAs) yields a 95.5% clearance rate, accompanied by recompensation in 61.8% of patients with Child-Turcotte-Pugh (CTP)-B cirrhosis.
Why this matters
- At 1 month of treatment, only 45.5% had switched from CTP-B to CTP-A, suggesting a growing effect over time.
- Subcohort of 89 patients with CTP-B cirrhosis receiving DAA therapy in the real-world prospective multicenter Italian LINA cohort; 41.6% were treatment-experienced.
- HCV genotypes: 1b (61.8%), 2 (22.5%), 1a (11.2%), 4 (3.4%), and 3 (1.1%).
- A 24-week course of ledipasvir/sofosbuvir (Harvoni) was most common (38.2%).
- Funding: None.
- 95.5% rate of sustained virologic response at 12 weeks posttreatment (SVR12).
- There were no discontinuations.
- At 12 weeks posttherapy, 50.6%, 48.3%, and 1.1% were downgraded to CTP-A, remained at CTP-B, or worsened to CTP-C, respectively.
- At last observation (median, 11 months; interquartile range, 6-21 months):
- 61.8% were downgraded to CTP-A.
- 33.7% remained CTP-B.
- 4.5% worsened to CTP-C.
- In multivariate analysis, decompensated cirrhosis at 1 month of treatment (OR, 67.28; P<.001 and prior antiviral therapy p predicted decompensated cirrhosis at last observation after adjusting for genotype viral load.>
- Small sample size.