Assessment of Doppler haemodynamic changes suggestive of portal hypertension in cirrhotic HCV patients after sustained virological response to direct antiviral agents

Abstract

Hepatitis C is an infectious disease caused by hepatitis C virus (HCV) which mainly attacks the liver cells. Near eighty percent of patients develop CHC that after many years may lead to cirrhosis or liver cancer. Egypt has the highest prevalence rate of HCV in the world. About 14.7% of the Egyptian people have HCV antibodies and 9.8% have an active infection. The death rate due to liver disease about 40,000 each year (near10% of all deaths). It is the second after the cardiac diseases. With the ultimate goal of achieving a more potent strategy to control transmission of HCV in Egypt, The Ministry of Health has set up 32specialized centers for the nationwide therapy of HCV infection. Standard treatment for chronic hepatitis C infection was pegylated-interferon (Peg IFN) and ribavirin (RBV). New era for management of chronic HCV using direct antiviral agents (DAAs) started in 2013. Clinically significant portal hypertension (CSPH) is defined as hepatic venous pressure gradient (HVPG) of 10 mmHg or greater . Ascites and gastroesophageal varices are the most frequent manifestations of clinically significant portal hypertension. Other complications as variceal bleeding, spontaneous bacterial peritonitis (SBP), and infections other than SBP, hepato-renal syndrome and hepatic encephalopathy parallel the severity of portal hypertension and substantially worsen the prognosis.