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Rep"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatitis C virus (HCV) infection affects 50\u00a0million people worldwide with around 242,000 deaths annually, mainly due to complications such as cirrhosis and hepatocellular carcinoma (HCC). Portal hypertension (PH) caused by cirrhosis leads to severe consequences, including esophageal varices (EV). This study aimed to evaluate the effectiveness and safety of direct-acting antiviral (DAA) treatment in patients with and without EV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis involved consecutive HCV-infected adults undergoing DAA therapy at 22 Polish hepatology centers from July 1, 2015, to December 31, 2022. Patients with cirrhosis were categorized based on the presence of EV diagnosed by gastroscopy. Treatment effectiveness was measured by sustained virologic response (SVR), with safety outcomes monitored for 12 weeks post-treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A population of 3393 HCV-infected patients with cirrhosis was divided into groups with (A,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009976) and without (B,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092417) EV. Group A showed a significantly higher prevalence of comorbidities and concomitant medications. Genotype (GT)1b infections predominated in both groups, and GT3 infections were more common in the EV group. Group A exhibited more severe liver disease, and higher rates of decompensation, HCC, and HBV co-infection. SVR was significantly higher in group B (91.5% vs. 96.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Male gender, GT3, EV presence, and Child-Pugh grade B were identified as independent negative SVR predictors. Group A had a worse safety profile, with notably higher adverse event incidence and mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DAA therapies are highly effective and well tolerated in patients with cirrhosis, but EV presence predicts poorer virologic responses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43440-024-00639-9","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T03:05:00Z","timestamp":1724123100000},"page":"1114-1129","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-world experience with direct-acting antiviral therapy in HCV-infected patients with cirrhosis and esophageal varices"],"prefix":"10.1007","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1180-9230","authenticated-orcid":false,"given":"Micha\u0142","family":"Brzd\u0119k","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Zar\u0119bska-Michaluk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Kukla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justyna","family":"Janocha-Litwin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Dybowska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ewa","family":"Janczewska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beata","family":"Lorenc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Berak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W\u0142odzimierz","family":"Mazur","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Tudrujek-Zdunek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakub","family":"Klapaczy\u0144ski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Piekarska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Sitko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0141ukasz","family":"Laurans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Parfieniuk-Kowerda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Flisiak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"639_CR1","unstructured":"Genus. accessed February 18,: Hepacivirus n.d. https:\/\/ictv.global\/report\/chapter\/flaviviridae\/flaviviridae\/hepacivirus (2024)."},{"key":"639_CR2","unstructured":"World Health Organization. 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Zar\u0119bska-Michaluk D has acted as a speaker for AbbVie and Gilead. Kukla M has no conflict of interest to declare. Janocha-Litwin J has no conflict of interest to declare. Dybowska D has received funding for participation in the conference from AbbVie. Janczewska E has acted as a speaker and\/or advisor for AbbVie, Gilead, MSD, Ipsen, and has received funding for clinical trials from AbbVie, Allergan, BMS, Celgene, Cymabay, Dr Falk Pharma, Exelixis, GSK, and MSD. Lorenc B has no conflict of interest to declare. Berak H has acted as a speaker and\/or advisor for Gilead, Abbvie, and MSD. Mazur W has acted as a speaker and\/or advisor for AbbVie, Gilead, Merck, and has received funding for clinical trials from AbbVie, Gilead, and Janssen. Tudrujek-Zdunek M has no conflict of interest to declare. Klapaczy\u0144ski J has acted as a speaker for Gilead and AbbVie. Piekarska A has acted as a speaker and\/or advisor for AbbVie, Gilead, Merck, and Roche. Sitko M has no conflict of interest to declare. Laurans \u0141 has no conflict of interest to declare. Parfieniuk-Kowerda A has no conflict of interest to declare. Flisiak R has acted as a speaker and\/or advisor, and has received funding for clinical research from AbbVie, Gilead, Merck, and Roche.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}