Calprotectin is a promising diagnostic biomarker for spontaneous bacterial peritonitis (SBP) among cirrhotic patients, but published studies report a wide variation of its diagnostic accuracy. We systematically searched six databases for eligible studies (i.e., all original studies that reported ascitic calprotectin as a diagnostic marker for SBP in cirrhotic patients), and assessed their quality with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We calculated the pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and diagnostic odds ratio (DOR) using the bivariate mixed-effect model. We constructed the summary receiver operating characteristic and determined the area under the curve (AUC). We registered the study protocol in PROSPERO (CRD42019125476). Our search retrieved 102 studies, of which 10 were included in the analysis. The overall risk of bias of these studies ranged from low to moderate. There was no heterogeneity from the threshold effect (Spearman correlation coefficient = 0.100, P value = 0.770). The pooled estimates [95% confidence intervals (CIs)] for ascitic calprotectin were as follows: sensitivity 0.91 (95% CI: 0.88–0.94), specificity 0.87 (95% CI: 0.68–0.96), PLR 7.18 (95% CI: 2.52–20.43), NLR 0.10 (95% CI: 0.07–0.15), DOR 71.91 (95% CI: 19.42–266.34), and AUC 0.92 (95% CI: 0.90–0.94). The sensitivity analysis did not detect outliers, and the model had a robust goodness of fit. There was no significant publication bias detected (Deeks test of asymmetry, P value = 0.79). Ascitic calprotectin is a promising diagnostic biomarker for SBP in cirrhotic patients.

Background: All oral direct-acting antivirals (DAAs) effectively treat chronic hepatitis C infection (HCV) and widely used for patients with compensated cirrhosis. However, data regarding their safety and efficacy in patients with decompensated cirrhosis are insufficient . The aim of this work was to test efficacy, safety and outcome of DAAs in the treatment of decompensated HCV related cirrhotic patients (CTP-B). Methods: prospective study among 62 chronic HCV cirrhotic patients, divided into two groups. Group I(the study group) included 32 patients with CTP-B treated for 12 weeks by sofosbuvir (SOF) 400 mg once daily plus Daclatasvir (DCV) 60 mg once daily plus Ribavirin (RBV) with initial dose 600 mg /day), while group II (the control group) included 30 patients with CTP-A treated by (SOF 400 mg once daily + DCV 60 mg once daily +RBV dosed according to body weight) for 12 weeks. According to the National Committee for control of viral hepatitis (NCCVH). Follow up after end of treatment (EOT) for 24weeks so the total period of the study 36 weeks Results: cases achieved SVR in Group I: 93.75% and in group II:100%, Liver parameters were improved from baseline to 24 weeks after end of treatment. The most common adverse effects were anemia, no patients died by the end of the study, but one case 3.1% in group I stopped treatment due to severe complications. Conclusion: Treatment with DAAs in patients with CTP-B is effective and safe, but patients remain at risk of life-threatening complications as HCC and liver-related morbidity.