{
      "number": 7,
      "subjects": [
        "QR"
      ],
      "eprintid": 3379,
      "date": "2024-12-07",
      "userid": 2,
      "official_url": "https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0016508524053599?via%3Dihub",
      "rev_number": 5,
      "creators": [
        {
          "name": {
            "lineage": null,
            "given": "Madhumita",
            "honourific": null,
            "family": "Premkumar"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Radha K",
            "honourific": null,
            "family": "Dhiman"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Ajay",
            "honourific": null,
            "family": "Duseja"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Rohit",
            "honourific": null,
            "family": "Mehtani"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Sunil",
            "honourific": null,
            "family": "Taneja"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Ekta",
            "honourific": null,
            "family": "Gupta"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Pankaj",
            "honourific": null,
            "family": "Gupta"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Anchal",
            "honourific": null,
            "family": "Sandhu"
          }
        },
        {
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            "given": "Prerna",
            "honourific": null,
            "family": "Sharma"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Sahaj",
            "honourific": null,
            "family": "Rathi"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Nipun",
            "honourific": null,
            "family": "Verma"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Anand V",
            "honourific": null,
            "family": "Kulkarni"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Harish",
            "honourific": null,
            "family": "Bhujade"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Sreedhara B",
            "honourific": null,
            "family": "Chaluvashetty"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Naveen",
            "honourific": null,
            "family": "Kalra"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Gagandeep S",
            "honourific": null,
            "family": "Grover"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "Jasvinder",
            "honourific": null,
            "family": "Nain"
          }
        },
        {
          "name": {
            "lineage": null,
            "given": "K Rajender",
            "honourific": null,
            "family": "Reddy"
          }
        }
      ],
      "dir": "disk0\/00\/00\/33\/79",
      "keywords": "Chronic Hepatitis C; DAAs; Decompensated Cirrhosis; Direct-Acting Antivirals; HCV Elimination; Hepatitis C Virus; Punjab Model; Recompensation",
      "lastmod": "2026-03-25 02:22:03",
      "ispublished": "pub",
      "pagerange": "1429-1445",
      "publisher": "Elsevier BV",
      "metadata_visibility": "show",
      "date_type": "published",
      "eprint_status": "archive",
      "status_changed": "2026-03-25 02:22:03",
      "volume": 167,
      "datestamp": "2026-03-25 02:22:03",
      "uri": "http:\/\/crdd.osdd.net\/open\/id\/eprint\/3379",
      "note": "copyright of this article belongs to Elsevier BV",
      "refereed": "TRUE",
      "contact_email": "kps.sengar@csir.res.in",
      "publication": "Gastroenterology",
      "abstract": "BACKGROUND & AIMS: Chronic hepatitis C-related decompensated cirrhosis is associated with lower sustained virologic response (SVR)-12 rates and variable regression of disease severity after direct-acting antiviral agents. We assessed rates of SVR-12, recompensation (Baveno VII criteria), and survival in such patients. METHODS: Between July 2018 and July 2023, patients with decompensated chronic hepatitis C-related cirrhosis after direct-acting antiviral agents treatment were evaluated for SVR-12 and then had 6-monthly follow-up. RESULTS: Of 6516 patients with cirrhosis, 1152 with decompensated cirrhosis (age 53.2 ± 11.5 years; 63% men; Model for End-stage Liver Disease-Sodium MELD-Na: 16.5 $\\pm$ 4.6; 87\\% genotype 3) were enrolled. SVR-12 was 81.8\\% after 1 course; ultimately SVR was 90.8\\% after additional treatment. Decompensation events included ascites (1098; 95.3\\%), hepatic encephalopathy (191; 16.6\\%), and variceal bleeding (284; 24.7\\%). Ascites resolved in 86\\% (diuretic withdrawal achieved in 24\\% patients). Recompensation occurred in 284 (24.7\\%) at a median time of 16.5 (interquartile range, 14.5-20.5) months. On multivariable Cox proportional hazards analysis, low bilirubin (adjusted hazard ratio aHR, 0.6; 95\\% confidence interval CI, 0.5-0.8; P < 0.001), international normalized ratio (aHR, 0.2; 95\\% CI, 0.1-0.3; P < 0.001), absence of large esophageal varices (aHR, 0.4; 95\\% CI, 0.2-0.9; P = 0.048), or gastric varices (aHR, 0.5; 95\\% CI, 0.3-0.7; P = 0.022) predicted recompensation. Portal hypertension progressed in 158 (13.7\\%) patients, with rebleed in 4\\%. Prior decompensation with variceal bleeding (aHR, 1.6; 95\\% CI, 1.2-2.8; P = 0.042), and presence of large varices (aHR, 2.9; 95\\% CI, 1.3-6.5; P < 0.001) were associated with portal hypertension progression. Further decompensation was seen in 221 (19\\%); 145 patients died and 6 underwent liver transplantation. A decrease in MELDNa of $\\geq$3 was seen in 409 (35.5\\%) and a final MELDNa score of <10 was seen in 335 (29\\%), but 2.9\\% developed hepatocellular carcinoma despite SVR-12. CONCLUSIONS: SVR-12 in hepatitis C virus-related decompensated cirrhosis in a predominant genotype 3 population led to recompensation in 24.7\\% of patients over a follow-up of 4 years in a public health setting. Despite SVR-12, new hepatic decompensation evolved in 19\\% and hepatocellular carcinoma developed in 2.9\\% of patients. (ClinicalTrials.gov, Number: NCT03488485).",
      "type": "article",
      "title": "Recompensation of chronic hepatitis C-related decompensated cirrhosis following direct-acting antiviral therapy: Prospective cohort study from a hepatitis C virus elimination program"
    }