Effectivness of antiviral therapy on cirrhotic patients after surgical approach

Abstract

Aim: The aim of this study was to assess the effects and risk-benefit of antiviral therapy in cirrhotic patients operated for portal hypertension. Methods: This study included 38 patients with viral-related liver cirrhosis,out of whom 18 patients (Group A) received IFN and splenectomy and 20 patients (Group B) recived only IFN therapy. Results: The effects of splenectomy and IFN therapy on peripheral blood counts and liver function were evaluated. Platelet and leukocyte counts were significantly higher in patients with splenectomy compared to the group that recived only antiviral therapy. The antiviral therapy was well tolerated with no severe complications in surgical group (group A):16 patients had completed IFN therapy, one patient discontinued because of septic shock and one because of thrombocytopenia. While in group B from total of 20 patients, 9 subjects had discontinued: because of thrombocytopenia-5, and 4 because absence of viral response. The viral response estimated at least 6 months after IFN therapy showed a sustained viral response in 55,5% of patients in group A and 25 % in group B. Conclusions: IFN- based therapy following splenectomy had an advantage in the maintenence of higher platelet and leukocyte counts, and splenectomy caused an increase in adherence to antiviral therapy. The combination therapy of splenectomy and long-term IFN significantly improved survival rate in patients with advanced HCV-related cirrhosis and portal hypertension.