Outcome of Direct-Acting Antiviral Drugs on Treatment of Naïve Cirrhotic and Non-cirrhotic HCV Patients in Assir Region, Saudi Arabia: A Retrospective Cohort Study

Context: Direct-acting antiviral drugs (DAAs) have revolutionized HCV treatment, but their long-term impact on liver disease severity, fibrosis progression, and hepatocellular carcinoma (HCC) incidence among treatment-na & iuml;ve cirrhotic and non-cirrhotic patients in Saudi Arabia remains underexplored. This study evaluated the sustained virological response (SVR), liver disease severity, fibrosis progression, and HCC incidence among treatment-na & iuml;ve cirrhotic and non-cirrhotic HCV patients treated with DAAs in Saudi Arabia. Methods and Materials: A retrospective cohort study was conducted at Assir Central Hospital, Saudi Arabia, from March 2019 to December 2022. The study enrolled 52 adults (>18 years) comprising both cirrhotic and non-cirrhotic HCV patients who had received DAA treatment at least 6 months (24 weeks) prior. Demographic data, laboratory results, HCV genotype, and viral load were collected. Liver fibrosis was assessed using Fibroscan, while liver disease severity was evaluated using Model for End-stage Liver Disease (MELD) and Child-Pugh scores. HCC screening was performed using alpha-fetoprotein (AFP), ultrasound, and triphasic CT abdomen. Results: Findings included no significant changes in laboratory values (INR, bilirubin, albumin, liver enzymes) before and after treatment. However, cirrhosis cases increased post-treatment (P = 0.033), while HCC incidence remained stable. The most prevalent HCV genotype was 4 (64%), with Sofosbuvir/Daclatasvir being the most prescribed medication (44%). Conclusion: DAA treatment in treatment-na & iuml;ve cirrhotic and non-cirrhotic HCV patients in Saudi Arabia demonstrated efficacy in achieving SVR and maintaining liver function. However, continued monitoring is crucial post-treatment, particularly for detecting fibrosis progression and cirrhosis development.