Evaluation of portal venous flow velocity before and after direct acting antiviral therapy in chronic hepatitis C: A cohort study

This study aimed to evaluate the changes in portal venous flow velocity before and after direct-acting antiviral (DAA) therapy in patients diagnosed with chronic hepatitis C (CHC). A total of 53 CHC patients (36 males, 17 females; mean age 61.8 ± 7.7 years) treated with DAA at the Gastroenterology Department of our institution were included, along with 55 healthy controls matched by age and sex. Portal vein flow velocity was measured using Doppler ultrasonography, before and after treatment. Biochemical parameters, aspartate aminotransferase to platelet ratio, and fibrosis-4 scores were also analyzed. The mean pretreatment portal vein velocities in patients before treatment were 12.1 m/s and 17.5 m/s in the control healthy individuals (P < .001). DAA therapy resulted in a 100% sustained viral response. The posttreatment velocity increased significantly to 18 m/s (P < .001). Aspartate aminotransferase and alanine aminotransferase levels were significantly decreased (P < .001), while serum albumin levels were increased (P = .008). Although the platelet count increased, the change was not statistically significant (P = .232). Significant improvements were observed in aspartate aminotransferase to platelet ratio and fibrosis-4 scores (P < .001). The cirrhotic and non-cirrhotic subgroups demonstrated significant increases in portal flow velocity and decreased fibrosis values. DAA therapy in CHC patients also improved portal hemodynamics and noninvasive fibrosis markers, suggesting a broader impact on liver health and portal circulation.