National Academy of Agricultural Sciences (NAAS)
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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 |
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.
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