title: Treatment of decompensated cirrhosis secondary to hepatitis C with antiviral therapy.
abstract: OBJECTIVE
  To treat decompensated hepatitis C patient with interferon, ribavirin and amantidine to ascertain the sustained viral response.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Shifa International Hospital, Islamabad, from January 2007 to January 2012.
  
  
  METHODS
  HCV PCR patients with decompensated hepatitis C, who had developed a complication like ascites, encephalopathy or variceal bleeding were included in the study. Those with uncontrolled ascites or other complications were excluded. Treatment with standard interferon 3 miU subcutaneously three times a week along with ribavirin 800 mg to 1200 mg and amantidine 100 mg b.i.d. was administered for 12 months. Patients were followed every month with CBC and ALT and HCV PCR was performed after 3 months to document early viral response. They had HCV PCR at the end of the treatment to document end of treatment response. All were further followed for another 6 months at monthly intervals and HCV PCR was performed at the end of this period to document sustained viral response.
  
  
  RESULTS
  In all, 165 patients were treated. Treatment had to be discontinued in 42 (26%) patients. Out of these, 16 patients died. Thus, 123 completed treatment. Sustained viral response was documented in 58 out of the 123 (47%) patients. Hepatic encephalopathy, gastrointestinal bleeding, sepsis and development of ascites were the major complications during treatment.
  
  
  CONCLUSIONS
  Forty seven percent of patients with decompensated hepatitis C cirrhosis were able to achieve sustained viral response after one year treatment with anti-viral therapy. However, complications developed during treatment and, therefore, frequent and close monitoring is necessary in these patients.
authors.affiliation: Department of Gastroenterology / Medicine, Shifa International Hospital, Islamabad.
authors.forename: Nasir
authors.initials: N
authors.lastname: Khokhar
authors.forename: Muhammad Omar
authors.initials: MO
authors.lastname: Qureshi
authors.forename: Tariq Khan
authors.initials: TK
authors.lastname: Niazi
mesh_terms: D000328:Adult; D000368:Aged; D000547:Amantadine / Q000008:administration & dosage / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012367:RNA, Viral / Q000032:analysis; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin; D000547:Amantadine