Value of Child-Turcotte-Pugh Score in Prediction of Treatment Response in “Difficult to Treat” Chronic HCV Cirrhotic Patients

Background and aim: The direct-acting antivirals (DAAs) treatment has greatly improved sustained virologic response (SVR) in chronic non-cirrhotic hepatitis C virus (HCV) patients and to less extent in those with cirrhosis. There is a stressing need for predicting the outcome of DAAs treatment especially in “difficult to treat” patients. This work aimed to study the value of the Child-Turcotte-Pugh (CTP) score in the prediction of treatment outcome with DAAs in “difficult to treat” chronic HCV patients. Materials and methods: A retrospective cohort study was conducted where files of 120 “difficult to treat” patients were randomly selected from the follow-up clinic. Patients’ data were collected before and after treatment including history taking, clinical examination, laboratory investigations, and abdominal ultrasonography. Child-Turcotte-Pugh (CTP) scores were calculated. Results: There was no significant difference in mean Child score between patients with and without SVR before treatment, while this difference became significant after treatment. The patients without complications showed a highly significant decrease in their mean Child score after treatment, while patients with complications did not show any significant differences. Conclusion: The baseline Child-Turcotte-Pugh score cannot predict the treatment response of DAAs in “difficult to treat” chronic HCV patients, but it is significantly associated with the occurrence of complications.