Predictors of Outcomes of Patients with HCV Related Decompensated Liver Cirrhosis under DAAS Therapy

Background: Direct-acting antivirals (DAAs) have transformed the management of hepatitis C virus (HCV) infection; however, their influence on outcomes in patients with decompensated cirrhosis remains incompletely understood. The objective of our study was to assess the impact of DAA therapy on hepatic function, the severity of the disease, and survival of patients with HCV-associated decompensated cirrhosis. Methods: Our retrospective single-center study included 60 patients with associated decompensated cirrhosis (Child-Turcotte-Pugh [CTP] score ≤12) treated with DAA regimens between 2017 and 2020. Patients underwent comprehensive assessments at the beginning of the study and during follow-up at 1st, 3rd, 6th, 12th, 18th, and 24th months. Sustained virologic response (SVR) was the primary outcome. Changes in hepatic function parameters, development of complications, and short-term survival were the secondary outcomes. Results: Significant improvements were noted in CTP (9.7±1.5 to 6.0±1.0) and Model for End-Stage Liver Disease (MELD) scores (21.7±3.2 to 6.5±2.3) at the sixth month after treatment. Additionally, substantial enhancements were observed in liver enzymes, albumin, bilirubin, coagulation profile, and platelet count following DAA therapy. Elevated SVR rates were achieved, with consistent HCV RNA undetectability from 6 months onwards. Conclusion: DAA therapy in patients with HCV-associated decompensated liver cirrhosis results in significant improvements in liver function, disease severity, and prognostic markers.. These findings highlight the potential of viral eradication to delay or avert the need for liver transplantation in this high-risk population.