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Time‐course changes in liver functional reserve after successful sofosbuvir/velpatasvir treatment in patients with decompensated cirrhosis

2021; Wiley; Volume: 52; Issue: 3 Linguagem: Inglês

10.1111/hepr.13739

1872-034X

Masanori Atsukawa, Akihito Tsubota, Chisa Kondo, Hidenori Toyoda, Makoto Nakamuta, Koichi Takaguchi, Tsunamasa Watanabe, Atsushi Hiraoka, Haruki Uojima, Toru Ishikawa, Motoh Iwasa, Toshifumi Tada, Akito Nozaki, Makoto Chuma, Shinya Fukunishi, Toru Asano, Chikara Ogawa, Hiroshi Abe, Keizo Kato, Naoki Hotta, Toshihide Shima, Kentaro Matsuura, Shigeru Mikami, Yoshihiko Tachi, Shinichi Fujioka, Hironao Okubo, Noritomo Shimada, Joji Tani, Asahiro Morishita, Isao Hidaka, Akio Moriya, Kunihiko Tsuji, Takehiro Akahane, Tomomi Okubo, Taeang Arai, Michika Kitamura, Kiyoshi Morita, Kazuhito Kawata, Yasuhito Tanaka, Takashi Kumada, Katsuhiko Iwakiri,

Liver Disease Diagnosis and Treatment

Direct-acting antivirals (DAAs) are currently available even for patients with decompensated cirrhosis. Reportedly, hepatic functional reserve improved in the short term after achievement of sustained virologic response (SVR). We aimed to clarify the outcomes after achievement of SVR in patients with decompensated cirrhosis who were treated by DAAs in real-world clinical practice.A prospective, multicenter study of 12-week sofosbuvir/velpatasvir was conducted in 86 patients with decompensated cirrhosis, who were evaluated for 48 weeks post-treatment.The cohort included 8 patients with Child-Pugh class A, 56 with B, and 22 with C. The proportion of Child-Pugh class A patients increased from 9.1% at baseline to 44.1% at 48 weeks post-treatment, while that of class B and C patients decreased from 66.2% to 35.1% and from 24.7% to 14.3%, respectively. Among the patients with Child-Pugh class B and C, univariate analysis identified low total bilirubin, Child-Pugh score, Child-Pugh class B, ALBI score, and high serum albumin as factors associated with improvement to Child-Pugh class A. The optimal cut-off value of the factors for predicting improvement to Child-Pugh class A were 1.4 mg/dl for total bilirubin, 2.9 g/dl for serum albumin, 8 points for Child-Pugh score, and -1.88 for ALBI score.Achievement of SVR with sofosbuvir/velpatasvir improved the liver functional reserve at 12 weeks post-treatment and maintained the stable effects until 48 weeks post-treatment in patients with decompensated cirrhosis. Specifically, the patients with less advanced conditions had the likelihood of improving to Child-Pugh class A at 48 weeks post-treatment.