{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:51:33Z","timestamp":1769730693271,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T00:00:00Z","timestamp":1526860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003407","name":"Ministero dell\u2019Istruzione, dell\u2019Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>The long\u2010term impact of sustained virological response (<jats:styled-content style=\"fixed-case\">SVR<\/jats:styled-content>) after direct\u2010acting antivirals (<jats:styled-content style=\"fixed-case\">DAA<\/jats:styled-content>s) on the hypercoagulability associated with <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> cirrhosis is unknown. We longitudinally evaluated the effect of <jats:styled-content style=\"fixed-case\">DAA<\/jats:styled-content>s treatment on cirrhotic coagulopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pro\u2010 and anticoagulant factor levels and thrombin generation were assessed in patients with <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>\u2010related cirrhosis at baseline, end of therapy (<jats:styled-content style=\"fixed-case\">EOT<\/jats:styled-content>), at 12, 24 and 48\u00a0weeks (W) after <jats:styled-content style=\"fixed-case\">EOT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010eight patients were enrolled (86% Child\u2019s A). <jats:styled-content style=\"fixed-case\">SVR<\/jats:styled-content> was 100%. Median factor <jats:styled-content style=\"fixed-case\">VIII<\/jats:styled-content> activity significantly decreased at <jats:styled-content style=\"fixed-case\">EOT<\/jats:styled-content>, 12\u00a0weeks and 24\u00a0weeks compared with baseline, whereas protein C significantly increased at 24\u00a0weeks and 48\u00a0weeks. Cirrhotic patients showed a slight but sustained increase in endogenous thrombin potential (<jats:styled-content style=\"fixed-case\">ETP<\/jats:styled-content>) with a statistically significant difference at <jats:styled-content style=\"fixed-case\">EOT<\/jats:styled-content>, 12\u00a0weeks, 24\u00a0weeks and 48\u00a0weeks compared with baseline. Conversely, thrombomodulin\u2010modified <jats:styled-content style=\"fixed-case\">ETP<\/jats:styled-content> was elevated before treatment and decreased over time to normal levels at 24\u00a0weeks and 48\u00a0weeks. The <jats:styled-content style=\"fixed-case\">ETP<\/jats:styled-content> ratio decreased slowly at <jats:styled-content style=\"fixed-case\">EOT<\/jats:styled-content> and 12\u00a0weeks, and was significantly decreased at 24\u00a0weeks and 48\u00a0weeks compared with baseline (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 for both comparisons), being not statistically different from <jats:styled-content style=\"fixed-case\">ETP<\/jats:styled-content> ratio measured in healthy controls. Child\u2019s B patients showed a significantly higher <jats:styled-content style=\"fixed-case\">ETP<\/jats:styled-content> ratio compared to Child\u2019s A at baseline and did not show any significant improvement in <jats:styled-content style=\"fixed-case\">ETP<\/jats:styled-content> ratio through 12\u00a0weeks. Two Child\u2019s B patients developed <jats:styled-content style=\"fixed-case\">PVT<\/jats:styled-content> with an incidence rate of 1.1% p\u2010yrs (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.18 to 3.58).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">DAA<\/jats:styled-content>s therapy in <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>\u2010related cirrhotic patients is associated with significant changes in thrombin generation suggesting a reversal of hypercoagulability particularly in Child\u2019s A patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13873","type":"journal-article","created":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T19:04:56Z","timestamp":1525806296000},"page":"2210-2218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Reversal of hypercoagulability in patients with <scp>HCV<\/scp>\u2010related cirrhosis after treatment with direct\u2010acting antivirals"],"prefix":"10.1111","volume":"38","author":[{"given":"Francesco Paolo","family":"Russo","sequence":"first","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit Department of Surgery, Oncology and Gastroenterology Padua University Hospital  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6734-7178","authenticated-orcid":false,"given":"Alberto","family":"Zanetto","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit Department of Surgery, Oncology and Gastroenterology Padua University Hospital  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-3741","authenticated-orcid":false,"given":"Elena","family":"Campello","sequence":"additional","affiliation":[{"name":"Thrombotic and Haemorrhagic Diseases Unit 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