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International Journal of Current Microbiology and Applied Sciences (IJCMAS)
IJCMAS is now DOI (CrossRef) registered Research Journal. The DOIs are assigned to all published IJCMAS Articles.
Index Copernicus ICI Journals Master List 2019 - IJCMAS--ICV 2019: 96.39 For more details click here
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National Academy of Agricultural Sciences (NAAS)
NAAS Score: *5.38 (2020)
[Effective from January 1, 2020]
For more details click here

ICV 2019: 96.39
Index Copernicus ICI Journals Master List 2019 - IJCMAS--ICV 2019: 96.39
For more details click here

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Original Research Articles

PRINT ISSN : 2319-7692
Online ISSN : 2319-7706
Issues : 12 per year
Publisher : Excellent Publishers
Email : editorijcmas@gmail.com / submit@ijcmas.com
Editor-in-chief: Dr.M.Prakash
Index Copernicus ICV 2018: 95.39
NAAS RATING 2020: 5.38

Int.J.Curr.Microbiol.App.Sci.2020.9(10): 3705-3714
DOI: https://doi.org/10.20546/ijcmas.2020.910.427


The Effect of Direct Acting Antivirals on Portal Hemodynamics in Patients with Post Hepatitis C Cirrhosis: Doppler Study
Amira Shaaban Soliman1*, Fathia El sayed Asal1, Sahar Abdel Tawab El yamani1,Amr Mohamed Tawfik Elbadry2, Nehad Ibrahim Hawash1 and Mahmoud Anees Khedr1
1Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine,Tanta University, Tanta, Egypt
 2Department of Radiodiagnosis, Faculty of Medicine, Tanta University, Tanta, Egypt
*Corresponding author
Abstract:

Hepatitis C viral clearance after receiving direct acting drugs had been established that results in reduced morbidity and mortality due to chronic liver disease, however how this affects clinical outcomes in patients with already established cirrhosis and portal hypertension (PH) is still controversial. We aimed to assess the effect of direct acting antivirals on portal hemodynamics by Doppler ultrasound in patients with post hepatitis C cirrhosis. Fifty patients with post hepatitis C cirrhosis as documented by Ultrasound. All patients received direct acting drugs for 12 weeks except for 2 patients received treatment for 24 weeks. Laboratory tests (liver function tests, complete blood picture, alpha feto protein, renal function tests, serum HBs antigen, Quantitative PCR for HCV RNA, modified Child-Pugh Score, Model for End stage Liver Disease Score (MELD) calculation, Ultrasound examination and Doppler ultrasound for assessment of (portal vein flow velocity (PVV), congestion index (C I), hepatic Arterial pulsatility and resistive indices (HAPI, HARI), and Liver vascular index (LVI) were performed before, at end of therapy and 6 months after the end of treatment for all patients. Twenty six male (52%) and 24 females (48 %) were included, their mean age 57.360, 46 patients were Child A. 47 patients achieved sustained virological response (SVR). Serum albumin, bilirubin, ALT, AST, hemoglobin, white blood cells and alpha feto protein were improved significantly 6 months later. As regard Doppler parameters there was a highly significant increase in Portal vein flow velocity (PVV) and liver vascular index (LVI), and decrease in congestion index (C I) ( P value< 0.001) at end of therapy and 6 months after end of therapy, hepatic artery pulsatility (HAPI) and resistive index (HARI) were significantly decreased at end of therapy (P value= 0.020, 0.008 respectively) and at 6 months after end of therapy(P value =0.011,<0.001 respectively). Achieving Sustained virologic response by the use of direct-acting antivirals in HCV related cirrhosis, improve liver blood flow and liver perfusion.


Keywords: HCV, Cirrhosis, Portal hypertension, Doppler, Direct acting antivirals
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How to cite this article:

Amira Shaaban Soliman, Fathia El sayed Asal, Sahar Abdel Tawab El Yamani, Amr Mohamed Tawfik Elbadry, Nehad Ibrahim Hawash and Mahmoud Anees Khedr. 2020. The Effect of Direct Acting Antivirals on Portal Hemodynamics in Patients with Post Hepatitis C Cirrhosis: Doppler Study.Int.J.Curr.Microbiol.App.Sci. 9(10): 3705-3714. doi: https://doi.org/10.20546/ijcmas.2020.910.427