Resolution of ascites and hepatic encephalopathy and absence of variceal bleeding in decompensated hepatitis C virus cirrhosis patients

BACKGROUND AND AIMS: The aims of this study were to examine changes in the proportion of decompensated hepatitis C virus (HCV) cirrhosis patients with ascites, hepatic encephalopathy, and variceal bleeding at pretreatment compared to 3 and 12 months post‐sustained virological response (SVR) and to compare pretreatment and post‐SVR model of end‐stage liver disease and Child‐Pugh scores and alpha‐fetoprotein levels. METHODS: Electronic medical records of 64 decompensated HCV cirrhosis patients who received direct‐acting antivirals were reviewed. The McNemar–Bowker test and the Wilcoxon‐Signed Rank test were used to compare patient outcomes. RESULTS: Ascites was resolved in 29% of patients 3 months post‐SVR (65% vs 36%, P < 0.01) and in 35% of patients 12 months post‐SVR (65% vs 30%, P = 0.07). Hepatic encephalopathy was resolved in 54% of patients 3 months post‐SVR (70% vs 16%, P < 0.01) and in 48% of patients 12 months post‐SVR (70% vs 22% P = 0.03). Variceal bleeding was absent in 32% of patients 3 months post‐SVR (35% vs 3%, P < 0.01) and in 27% of patients 12 months post‐SVR (35% vs 8%, P < 0.01). Alpha‐fetoprotein levels were significantly reduced post‐SVR, but model of end‐stage liver disease and Child‐Pugh scores were not. CONCLUSIONS: Decompensated HCV cirrhosis patients who achieved SVR with direct‐acting antiviral treatment had significant reductions in manifestations of hepatic decompensation sustainable up to 1 year post‐SVR.