The Real-World Safety and Efficacy of Directly Acting Antiviral Therapy for the Treatment of Patients with Hepatitis C Infection and Decompensated Cirrhosis

Abstract
Background: HCV was considered a major health problem worldwide before the discovery of direct acting antiviral therapy. Patients with chronic HCV and decompensated cirrhosis are not uncommon and represent the greatest thera-peutic challenge.
Aim of Study: The primary aim of this study is to assess safety, efficacy and tolerability of all oral DAAs in the treatment of a group of difficult-to-treat population (HCV genotype 4-related decompensated cirrhosis).
Patients and Methods: Forty (40) patients with chronic HCV infection and decompensated cirrhosis received different combinations of direct acting antivirals in the form of of sofosbuvir-daclatasvir and sofosbuvir-ledipasvir ± ribavirin for 24wks (for the regimens not containing ribavirin) and 12wks (for the regimens containing ribavirin).
All patients in this study were subjected to: History taking regarding demographic data and risk factors predisposing them to HCV infection, full clinical examination, laboratory investigations (CBC, liver functions, PT and INR), CTP scoring before treatment and 12wks after the end of treatment (SVR).
Results: Thirty (30) patients complete the duration of treatment and developed Sustained Virological Response (SVR) and those patients showed a significant improvement clinically regarding amount of ascites (p=<0.01), in laboratory findings regarding platelets count (p=<0.05), liver transami-nases (p=Conclusion: Direct acting antivirals are highly effective and showed great improvement in patients with chronic hepatitis C and decompensated cirrhosis clinically and in laboratory findings.