Changes of Liver Function Parameters in Hepatitis C Virus - Associated Compensated Liver Cirrhosis Patients Treated by Sofosbuvir/Daclatasvir +/- Ribavarin Therapy

Abstract

Introduction: Successful interferon free (IFN –free) treatment for hepatitis C patients are associated with improvement of liver function and blood parameters. To what extent of improvement do we see in compensated cirrhotics is unknown.  Aim: To study liver function parameters in compensated cirrhotic HCV(Hepatitis C) patients receiving Sofosbuvir/Daclatasvir +/- Ribavarin therapy.  Methodology: We here studied 55 consecutive patients with HCV associated liver cirrhosis including 43 patients with Child A cirrhosis and 12 patients with Child’s B receiving combinations of direct acting antivirals Sofosbuvir/Daclatasvir with/without ribavirin that achieved sustained virological response at 12 weeks (SVR12) post treatment. The majority of patients was infected with HCV genotype 3 (n = 36); HCV genotypes 1a and 1b were present in 11 and 8 patients, respectively. Results: Parameters including Albumin, Prothrombin time, Hemoglobin showed no statistical significant difference post treatment in this study, however parameters of Platelet count, Bilirubin, Alanine Transferase and AFP all improved in the majority of patients during antiviral therapy irrespectively of the underlying HCV genotype. For AFP, those with abnormal readings, 46.2% had reverted to a normal AFP after treatment. There was also an increase in platelet count from week 0-4 with the mean increase of 16.33, then plateauing from weeks 4-24 weeks. For those with abnormal ALT at Week 0, 73.7% of them reverted to having normal ALT by week 24. Conclusion: This real-world multi centre study showed that sofosbuvir /daclatasvir +/- ribavirin therapies in patients that have achieved SVR12 may indeed restore most liver and blood parameters in early compensated liver cirrhotics when HCV replication is successfully treated irrespective of the underlying HCV genotype. These improvements are maintained once treatment has ended. These findings are congruent with other real world studies that was done in decompensated cirrhotics receiving interferon free therapies.