Regression of fibrosis and improvement of portal hemodynamics after achievement of sustained viral response (SVR) in patients with chronic hepatitis C (HCV) is a subject of debate in different studies. Some studies reported improvement in the degree of fibrosis, while others did not find significant changes. We aimed to evaluate changes in liver fibrosis, portal hemodynamics and clinical outcomes in patients with chronic HCV-related liver cirrhosis after the achievement of SVR with direct-acting antiviral drugs (DAAs). In our prospective longitudinal study, a total of 100 patients with chronic HCV infection-related liver cirrhosis were recruited, received DAAs, and completed the follow-up period. Clinical evaluation for assessment of liver disease severity using MELD and Child–Pugh class and scores were done. A noninvasive assessment of liver fibrosis using serum biomarkers (APRI index & FIB4 score) and share wave elastography (SWE) was done. Portal hemodynamic evaluation using Doppler ultrasound was done. All were done at baseline and 3 and 12 months after the end of therapy. A significant reduction in the degree of fibrosis was observed. Share wave elastography (SWE) readings showed 19.79% and 30.45% reduction 3 and 12 months after the end of therapy respectively (P < 0.001). Regarding the FIB4 score, the percentage of score reduction was 19.8% and 26.46% 3 and 12 months after the end of therapy, respectively (P < 0.01). APRI scores showed 22.6% and 41.09% reduction 3 and 12 months after the end of therapy respectively (P < 0.001). Significant improvement in Child–Pugh scores 3 and 12 months after the end of treatment was observed. Doppler ultrasound showed a significant increase in portal vein flow velocity, a significant decrease in time average mean velocity, and cross-section area 12 months after the end of treatment. There was a considerable degree of reduction of liver fibrosis, improvement of portal hemodynamics, and Child–Pugh score in cirrhotic HCV patients who achieved SVR after DAAs. ClinicalTrials.gov, ID: NCT03241823 . Registered on 08 May 2017.

中文翻译：

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对直接作用抗病毒药物 (DAA) 持续病毒学应答后 HCV 相关肝硬化患者的肝纤维化、门静脉血流动力学变化和疾病严重程度的评估

慢性丙型肝炎（HCV）患者在实现持续病毒应答（SVR）后纤维化的消退和门静脉血流动力学的改善是不同研究中争论的主题。一些研究报告纤维化程度有所改善，而另一些研究则没有发现显着变化。我们的目的是评估慢性 HCV 相关肝硬化患者使用直接抗病毒药物 (DAA) 实现 SVR 后肝纤维化、门静脉血流动力学和临床结果的变化。在我们的前瞻性纵向研究中，总共招募了 100 名慢性 HCV 感染相关肝硬化患者，接受 DAA 治疗并完成随访期。使用 MELD 和 Child-Pugh 分级和评分对肝病严重程度进行临床评估。使用血清生物标志物（APRI 指数和 FIB4 评分）和共享波弹性成像 (SWE) 对肝纤维化进行无创评估。使用多普勒超声进行门静脉血流动力学评估。所有这些均在基线以及治疗结束后 3 个月和 12 个月时完成。观察到纤维化程度显着降低。共享波弹性成像 (SWE) 读数显示治疗结束后 3 个月和 12 个月分别减少 19.79% 和 30.45%（P < 0.001）。对于FIB4评分，治疗结束后3个月和12个月评分下降百分比分别为19.8%和26.46%（P < 0.01）。治疗结束后 3 个月和 12 个月，APRI 评分分别降低 22.6% 和 41.09%（P < 0.001）。治疗结束后 3 个月和 12 个月观察到 Child-Pugh 评分显着改善。治疗结束12个月后，多普勒超声显示门静脉血流速度显着增加，时间平均速度和横截面积显着下降。DAA 后实现 SVR 的肝硬化 HCV 患者的肝纤维化有相当程度的减少，门静脉血流动力学和 Child-Pugh 评分得到改善。ClinicalTrials.gov，ID：NCT03241823。注册于 2017 年 5 月 8 日。