{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T02:49:26Z","timestamp":1771037366814,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T00:00:00Z","timestamp":1726790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sustained virologic responses (SVRs) lead to a decrease in portal hypertension, the regression of fibrosis, and the improvement in the hepatic synthesis of procoagulant and anticoagulant factors. We aimed to assess the influence of SVR on coagulation parameters in cirrhotic patients with HCV treated with DAAs. Methods: We performed a prospective study in the Institute of Gastroenterology and Hepatology Iasi, Romania, between January 2022 and February 2024. We included patients diagnosed with compensated and decompensated HCV-related liver cirrhosis, treated with direct antivirals (PrOD \u00b1 RBV or SOF\/LED \u00b1 RBV) for 12\/24 weeks. Blood samples for biochemical, immunological, and coagulation tests were collected at the baseline, end of treatment (EOT), and once sustained virological response had been achieved over a period of 12\/24 weeks (SVR12\/24). Results: We analyzed a group of 52 patients with HCV-related liver cirrhosis, predominantly female (68.0%), and the degree of severity of cirrhosis placed the patients mainly in Child\u2013Pugh classes B (40%) and C (36%). All patients achieved SVRs. The MELD score decreased at EOT (13.48 \u00b1 4.273; p = 0.001) and SVR (9.88 \u00b1 2.774; p = 0.000), compared to the baseline (14.92 \u00b1 4.707). The FibroScan values decreased at SVR (17.596 \u00b1 3.7276; p = 0.000) compared to the baseline (26.068 \u00b1 7.0954). For all common coagulation parameters (platelets, INR, PT, fibrinogen, aPTT), there was a trend towards improvement during treatment, including changes which were statistically significant for the majority of patients. Factor II was low at the baseline (75.40 \u00b1 7.506) but increased at EOT (87.40 \u00b1 9.587) and, later, at SVR (99.12 \u00b1 11.695; p = 0.000). The FVIII values increased at the baseline (175.52 \u00b1 16.414) and decreased at EOT (151.48 \u00b1 13.703) and SVR (143.40 \u00b1 13.937). The FvW values decreased during treatment (146.84 \u00b1 9.428, at baseline; 141.32 \u00b1 9.690, p = 0.000, at EOT; and 126.68 \u00b1 17.960, at SVR). In regard to the anticoagulant factors (PC, PS, ATIII), a significant improvement was brought on by SVR. Advanced stages of liver disease showed the most diminished FII activity, while at the baseline and in Child\u2013Pugh C patients we recorded the highest values of FVIII and FvW. Conclusions: Our study proved that the \u201creset\u201d of coagulopathy might be due to the improvement in liver function due to viral eradication secondary to AAD therapy.<\/jats:p>","DOI":"10.3390\/medicina60091539","type":"journal-article","created":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T07:38:57Z","timestamp":1726817937000},"page":"1539","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Treatment with Direct Antivirals on Coagulation Parameters in Patients with Hepatitis C Virus-Related Liver Cirrhosis and Sustained Virological Response"],"prefix":"10.3390","volume":"60","author":[{"given":"Laura","family":"Huiban","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol","family":"Stanciu","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0891-5961","authenticated-orcid":false,"given":"Cristina Maria","family":"Muzica","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5925-1232","authenticated-orcid":false,"given":"Irina","family":"Girleanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6956-6686","authenticated-orcid":false,"given":"Raluca","family":"Avram","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Damian","sequence":"additional","affiliation":[{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8678-0663","authenticated-orcid":false,"given":"Robert","family":"Nastasa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8526-988X","authenticated-orcid":false,"given":"Ermina","family":"Stratina","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0441-3980","authenticated-orcid":false,"given":"Sebastian","family":"Zenovia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horia","family":"Minea","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1460-6559","authenticated-orcid":false,"given":"Remus","family":"Stafie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6459-6996","authenticated-orcid":false,"given":"Adrian","family":"Rotaru","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5621-548X","authenticated-orcid":false,"given":"Ana-Maria","family":"Singeap","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2497-9236","authenticated-orcid":false,"given":"Stefan","family":"Chiriac","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana-Miruna","family":"Balmus","sequence":"additional","affiliation":[{"name":"CENEMED Platform for Interdisciplinary Research, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"},{"name":"Department of Exact Sciences and Natural Sciences, Institute of Interdisciplinary Research, \u201cAlexandru Ioan Cuza\u201d University of Iasi, 700057 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9144-5520","authenticated-orcid":false,"given":"Anca","family":"Trifan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700015 Iasi, Romania"},{"name":"Institute of Gastroenterology and Hepatology, \u201cSt. Spiridon\u201d University Hospital, 700111 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1055\/s-0040-1702944","article-title":"Postsustained Virological Response Management in Hepatitis C Patients","volume":"40","author":"Masetti","year":"2020","journal-title":"Semin. Liver Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jhep.2024.04.007","article-title":"EASL position paper on clinical follow-up after HCV cure","volume":"81","author":"Reiberger","year":"2024","journal-title":"J. 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