Transient elastography and platelet count as noninvasive predictors of gastroesophageal varices in patients with compensated hepatitis C virus–related liver cirrhosis

We aimed to clarify the relationship between sustained virological response (SVR) and gastroesophageal varices (GEVs) progression among hepatitis C virus (HCV)-related liver cirrhosis (LC) patients treated with interferon (IFN)-based therapies (n = 18) and direct-acting antiviral (DAA)-based therapies (n = 37), and LC patients with no SVR (n = 71) who had already developed GEVs. Factors influencing GEVs progression were also examined. During the follow-up period, GEVs progression was observed in 50 patients (39.7%). The 3-year cumulative GEVs progression rates in the DAA-SVR group, the IFN-SVR group, and the non-SVR group were 32.27%, 5.88%, and 33.76%, respectively (overall p value = 0.0108). Multivariate analysis revealed that sex (p = 0.0430), esophageal varices (EVs) F2 or more (p < 0.0001), and DAA-SVR (p = 0.0126, IFN-SVR as a reference) and non-SVR (p = 0.0012, IFN-SVR as a reference) were independent predictors for GEVs progression. The proportion of GEVs progression in patients with no or F1 EVs was significantly lower than that in patients with F2 or F3 EVs (33.9% (38/112) vs. 85.7% (12/14), p = 0.0003). In conclusion, IFN-based therapies can have a favorable impact for preventing GEVs progression in HCV-related LC patients with GEVs. Clinicians should be aware of a point of no return where SVR is no longer capable of avoiding GEVs progression.

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Platelet count/prothrombin time ratio as a noninvasive predictor for esophageal varices in Egyptian patients with hepatitis C virus-related liver cirrhosis

Egyptian Liver Journal ◽

10.1097/01.elx.0000546497.06251.77 ◽

2018 ◽

Vol 8 (2) ◽

pp. 68-71

Author(s):

Mohamed H.A. Fouad ◽

Ahmed I. Elshafie ◽

Tamer A.R. Ali ◽

Mohamed Hassany ◽

Ahmed H. Soliman ◽

...

Keyword(s):

Liver Cirrhosis ◽

Platelet Count ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Prothrombin Time ◽

Esophageal Varices ◽

Time Ratio ◽

Egyptian Patients ◽

Prothrombin Time Ratio

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Dynamic of liver stiffness values by means of transient elastography in patients with hepatitis C virus liver cirrhosis undergoing Interferon free treatment

Journal of Hepatology ◽

10.1016/s0168-8278(17)30796-1 ◽

2017 ◽

Vol 66 (1) ◽

pp. S245

Author(s):

I. Sporea ◽

R. Lupusoru ◽

R. Mare ◽

A. Popescu ◽

R. Sirli ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Transient Elastography ◽

Liver Stiffness ◽

Free Treatment

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Using vibration controlled transient elastography and FIB-4 to assess liver cirrhosis in a hepatitis C virus infected population

Medicine ◽

10.1097/md.0000000000026200 ◽

2021 ◽

Vol 100 (23) ◽

pp. e26200

Author(s):

Nabil Saleem ◽

Lesley S. Miller ◽

Alia S. Dadabhai ◽

Emily J. Cartwright

Keyword(s):

Liver Cirrhosis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Transient Elastography ◽

Infected Population

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Platelet Count Improvement after Chronic Hepatitis C Treatment among Cirrhotic Patients Who Achieved Sustained Virological Response: Realworld Results from 2186 Patients in Egypt

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200917113650 ◽

2020 ◽

Vol 20 ◽

Author(s):

Rehab Badawi ◽

Shaimaa Soliman ◽

Lobna Aboali ◽

Mahmoud Elkadeem ◽

Asem Elfert ◽

...

Keyword(s):

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Platelet Count ◽

Hepatitis C ◽

Sustained Virological Response ◽

Virological Response ◽

Hcv Rna ◽

End Of Treatment ◽

Pugh Class ◽

Direct Acting

Background & Aims: This study aimed to assess the changes in platelet counts of patients with liver cirrhosis due to chronic HCV, who achieved sustained virological response (SVR) after taking direct acting antivirals (DAAs) in a large cohort study in Egypt. Methods: This multicenter observational retrospective study was carried out on 2500 chronic hepatitis C virus (HCV) infected patients who achieved (SVR) after treatment with direct acting antiviral drugs (DAA). HCV infection was confirmed by positive PCR for HCV RNA infection. SVR was defined as a negative PCR test for HCV-RNA 12 weeks after completion of DAA therapy. Platelets count was measured before therapy, during therapy, at the end of treatment, and 12 weeks after the end of the treatment. Results: There were 2186 patients enrolled in the study; 1866 (85.4%) were treatment naïve. There were 1006 (46%) males and 1180 (54%) females. Mean age was 50.82± 11.66 years, 2142 (98 %.0) patients achieved SVR, 2118 (96.9%) patients had Child -Pugh class A cirrhosis, and 68 (3.1%) had Child -Pugh class B liver cirrhosis. A significant increase of the platelets count was detected at the end of treatment in comparison to the pretreatment levels (P<0.001), and after achieving SVR (P <0.001) when compared to the pretreatment values. Conclusion: Improvement of platelets count occurs after HCV therapy with DAAS in patients with liver cirrhosis. These results suggested that HCV eradication may have a role in improvement of platelet count.

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Enhanced immune responses, PI3K/AKT and JAK/STAT signaling pathways following hepatitis C virus eradication by direct-acting antiviral therapy among Egyptian patients: a case control study

Pathogens and Disease ◽

10.1093/femspd/ftab008 ◽

2021 ◽

Author(s):

Haidi Karam-Allah Ramadan ◽

Gamal Badr ◽

Nancy K Ramadan ◽

Aml Sayed

Keyword(s):

Immune Response ◽

Liver Cirrhosis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Immune Responses ◽

Signaling Pathways ◽

Liver Diseases ◽

Stat Signaling ◽

Chronic Hcv ◽

Direct Acting

Abstract The use of direct-acting antivirals (DAAs) therapy for the treatment of hepatitis C virus (HCV) results in a high sustained virological response (SVR) and subsequently alters liver immunologic environment. However, hepatocellular carcinoma (HCC) may occur after DAAs treatment. We aimed to clarify changes of immune responses, PI3K/AKT and JAK/STAT signaling pathways in HCV-induced liver diseases and HCC following DAAs treatment. Four cohorts are classified as chronic HCV patients, HCV-related cirrhosis without HCC, HCV-related cirrhosis and HCC, and healthy control group. The patient groups were further divided into treated or untreated with DAAs with SVR12. Increased percentages of CD3, CD8 and CD4, decreased CD4/FoxP3/CD25, CD8/PD-1 and CD19/PDL-1 were found in DAAs-treated patients in the three HCV groups. Following DAAs therapy, the levels of ROS, IL-1β, IL-6, IL-8 and TNF-α were significantly decreased in the three HCV groups. Treated HCV patients showed up regulation of p-AKT and p-STAT5 and down regulation of p-STAT3, HIF-1α and COX-2. In conclusion, DAAs enhance the immune response in chronic HCV and liver cirrhosis, hence our study is the first to show change in PI3K/AKT and JAK/STAT signaling pathways in different HCV-induced liver diseases after DAAs. In chronic HCV, DAAs have better impact on the immune response while in liver cirrhosis not all immune changes were prominent.

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