{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T03:55:13Z","timestamp":1781582113173,"version":"3.54.5"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T00:00:00Z","timestamp":1493337600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2018,4,28]],"date-time":"2018-04-28T00:00:00Z","timestamp":1524873600000},"content-version":"am","delay-in-days":365,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions"},{"start":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T00:00:00Z","timestamp":1493337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>Direct\u2010acting antiviral agents (DAAs) are highly effective and well tolerated in patients with chronic hepatitis C virus infection, including those with compensated cirrhosis. However, fewer data are available in patients with more advanced liver disease. Our retrospective, noninterventional, national, multicenter study in patients from the Spanish Hepa\u2010C registry investigated the effectiveness and safety of interferon\u2010free DAA regimens in patients with advanced liver disease, including those with decompensated cirrhosis, in routine practice (all currently approved regimens were registered). Patients transplanted during treatment or within 12 weeks of completing treatment were excluded. Among 843 patients with cirrhosis (Child\u2010Turcotte\u2010Pugh [CTP] class A, n = 564; CTP class B\/C, n = 175), 90% achieved sustained virologic response 12 weeks after treatment (SVR12). Significant differences in SVR12 and relapse rates were observed between CTP class A and CTP class B\/C patients (94% versus 78%, and 4% versus 14%, respectively; both <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Serious adverse events (SAEs) were more common in CTP class B\/C versus CTP class A patients (50% versus 12%, respectively; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Incident decompensation was the most common serious adverse event (7% overall). Death rate during the study period was 16\/843 (2%), significantly higher among CTP class B\/C versus CTP class A patients (6.4% versus 0.9%; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). Baseline Model for End\u2010Stage Liver Disease (MELD) score alone (cut\u2010off 18) was the best predictor of survival. <jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: Patients with decompensated cirrhosis receiving DAAs present lower response rates and experience more SAEs. In this setting, a MELD score \u226518 may help clinicians to identify those patients with a higher risk of complications and to individualize treatment decisions. (H<jats:sc>epatology<\/jats:sc> 2017;65:1810\u20101822).<\/jats:p>","DOI":"10.1002\/hep.29097","type":"journal-article","created":{"date-parts":[[2017,2,7]],"date-time":"2017-02-07T16:33:19Z","timestamp":1486485199000},"page":"1810-1822","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":89,"title":["Treatment of hepatitis C virus infection in patients with cirrhosis and predictive value of model for end\u2010stage liver disease: Analysis of data from the Hepa\u2010C registry"],"prefix":"10.1097","volume":"65","author":[{"given":"Carlos","family":"Fern\u00e1ndez Carrillo","sequence":"first","affiliation":[{"name":"Liver Unit,Hospital Universitario Puerta de Hierro\u2010Majadahonda,IDIPHIM, CIBERehd, Majadahonda,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabela","family":"Lens","sequence":"additional","affiliation":[{"name":"Liver Unit,Hospital Cl\u00ednic de Barcelona, University of 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Sof\u00eda,IMIBIC, CIBERehd,C\u00f3rdoba,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Buti","sequence":"additional","affiliation":[{"name":"Liver Unit,Hospital Universitario Vall d'Hebr\u00f3n,CIBERehd,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Llu\u00eds","family":"Castells","sequence":"additional","affiliation":[{"name":"Liver Unit,Hospital Universitario Vall d'Hebr\u00f3n,CIBERehd,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00edn","family":"Albillos","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department, Hospital Universitario Ram\u00f3n y Cajal,University of Alcal\u00e1, IRYCIS, CIBERehd,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Romero","sequence":"additional","affiliation":[{"name":"Digestive Diseases Unit,Hospital Universitario Virgen de Valme,CIBERehd,Sevilla,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Turnes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Complejo Hospitalario Universitario de Pontevedra and IISGS,Pontevedra,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Pons","sequence":"additional","affiliation":[{"name":"Digestive Service,Hospital General Universitario de Castell\u00f3n,Castell\u00f3n de la Plana,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Moreno\u2010Planas","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Complejo Hospitalario Universitario de Albacete,Albacete,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Javier","family":"Moreno\u2010Palomares","sequence":"additional","affiliation":[{"name":"Internal Medicine,Hospital General de Segovia,Segovia,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conrado","family":"Fern\u00e1ndez\u2010Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n,Alcorc\u00f3n,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Garc\u00eda\u2010Samaniego","sequence":"additional","affiliation":[{"name":"Liver Unit,Hospital Universitario La Paz,CIBERehd, IdiPAZ,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mart\u00edn","family":"Prieto","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Digestiva, Unidad de Hepatolog\u00eda,Hospital Universitari i Polit\u00e8cnic La Fe and CIBERehd,Valencia,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Fern\u00e1ndez Bermejo","sequence":"additional","affiliation":[{"name":"Digestive Service,Hospital San Pedro de 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