Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy
Background and aims: The regression of liver fibrosis and portal hypertension (PH) and their influence on the natural history of compensated hepatitis C virus (HCV)-related cirrhosis has not been studied previously. Our objective was to evaluate the influence of sustained virologic response (SVR) on...
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| Format: | Article |
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Aran Ediciones
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| Series: | Revista Espanola de Enfermedades Digestivas |
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| Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000100004&lng=en&tlng=en |
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| author | Ángela Puente Joaquín Cabezas María Jesús López Arias José Ignacio Fortea María Teresa Arias Ángel Estébanez Fernando Casafont Emilio Fábrega Javier Crespo |
| author_facet | Ángela Puente Joaquín Cabezas María Jesús López Arias José Ignacio Fortea María Teresa Arias Ángel Estébanez Fernando Casafont Emilio Fábrega Javier Crespo |
| author_sort | Ángela Puente |
| collection | DOAJ |
| description | Background and aims: The regression of liver fibrosis and portal hypertension (PH) and their influence on the natural history of compensated hepatitis C virus (HCV)-related cirrhosis has not been studied previously. Our objective was to evaluate the influence of sustained virologic response (SVR) on the portal pressure gradient (HVPG) and non-invasive parameters of PH and prognostic factors of response. Methods: Sixteen patients with compensated HCV genotype 1-related cirrhosis with PH (HVPG > 6 mmHg) without beta-blocker therapy were considered as candidates for PEGα2a + RBV + BOC (48 weeks; lead-in and accepted stopping rules). A hemodynamic study and Fibroscan® were performed at baseline, at eight weeks and, in the case of SVR, 24 weeks after treatment. In each hemodynamic study, serum samples were analyzed for inflammatory biomarkers associated with PH. Results: In eight cases, SVR was obtained; five patients relapsed, and treatment was stopped early for non-response to lead in (one case) and a decrease of < 3 log at week 8 (two patients). Compared to baseline, there was a significant decrease in HVPG and Fibroscan® at weeks 8 and 72 (10.31 ± 4.3 vs 9.4 ± 5.04 vs 6.1 ± 3.61 mmHg, p < 0.0001 and 21.3 ± 14.5 vs 16.2 ± 9.5 vs 6.4 ± 4.5 kPa, p < 0.0001, respectively). The average HVPG decrease in SVR was 40.8 ± 17.53%, achieving an HVPG < 6 mmHg in five patients (62.5%) and a Fibroscan® < 7.1 kPa in three patients (37.5%). Conclusions: Complete hemodynamic response (HVPG < 6 mmHg) and fibrosis regression (Fibroscan® < 7.1 kPa) occur in more than half and one-third of patients achieving SVR, respectively, and must be another target in cirrhotic patients with SVR. |
| first_indexed | 2024-12-23T23:14:24Z |
| format | Article |
| id | doaj.art-c509f5b9a794423bb1d2f332676708f1 |
| institution | Directory Open Access Journal |
| issn | 1130-0108 |
| language | English |
| last_indexed | 2024-12-23T23:14:24Z |
| publisher | Aran Ediciones |
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| series | Revista Espanola de Enfermedades Digestivas |
| spelling | doaj.art-c509f5b9a794423bb1d2f332676708f12022-12-21T17:26:34ZengAran EdicionesRevista Espanola de Enfermedades Digestivas1130-01081091172510.17235/reed.2016.4235/2016S1130-01082017000100004Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapyÁngela Puente0Joaquín Cabezas1María Jesús López Arias2José Ignacio Fortea3María Teresa Arias4Ángel Estébanez5Fernando Casafont6Emilio Fábrega7Javier Crespo8Hospital Universitario Marqués de ValdecillaHospital Universitario Marqués de ValdecillaHospital Universitario Marqués de ValdecillaHospital Universitario Marqués de ValdecillaHospital Universitario Marqués de ValdecillaResearch & Investigation Institute Marqués de Valdecilla (IDIVAL)Hospital Universitario Marqués de ValdecillaHospital Universitario Marqués de ValdecillaHospital Universitario Marqués de ValdecillaBackground and aims: The regression of liver fibrosis and portal hypertension (PH) and their influence on the natural history of compensated hepatitis C virus (HCV)-related cirrhosis has not been studied previously. Our objective was to evaluate the influence of sustained virologic response (SVR) on the portal pressure gradient (HVPG) and non-invasive parameters of PH and prognostic factors of response. Methods: Sixteen patients with compensated HCV genotype 1-related cirrhosis with PH (HVPG > 6 mmHg) without beta-blocker therapy were considered as candidates for PEGα2a + RBV + BOC (48 weeks; lead-in and accepted stopping rules). A hemodynamic study and Fibroscan® were performed at baseline, at eight weeks and, in the case of SVR, 24 weeks after treatment. In each hemodynamic study, serum samples were analyzed for inflammatory biomarkers associated with PH. Results: In eight cases, SVR was obtained; five patients relapsed, and treatment was stopped early for non-response to lead in (one case) and a decrease of < 3 log at week 8 (two patients). Compared to baseline, there was a significant decrease in HVPG and Fibroscan® at weeks 8 and 72 (10.31 ± 4.3 vs 9.4 ± 5.04 vs 6.1 ± 3.61 mmHg, p < 0.0001 and 21.3 ± 14.5 vs 16.2 ± 9.5 vs 6.4 ± 4.5 kPa, p < 0.0001, respectively). The average HVPG decrease in SVR was 40.8 ± 17.53%, achieving an HVPG < 6 mmHg in five patients (62.5%) and a Fibroscan® < 7.1 kPa in three patients (37.5%). Conclusions: Complete hemodynamic response (HVPG < 6 mmHg) and fibrosis regression (Fibroscan® < 7.1 kPa) occur in more than half and one-third of patients achieving SVR, respectively, and must be another target in cirrhotic patients with SVR.http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000100004&lng=en&tlng=enPortal pressure gradientPortal hypertensionTriple therapySVRFibroscan® |
| spellingShingle | Ángela Puente Joaquín Cabezas María Jesús López Arias José Ignacio Fortea María Teresa Arias Ángel Estébanez Fernando Casafont Emilio Fábrega Javier Crespo Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy Revista Espanola de Enfermedades Digestivas Portal pressure gradient Portal hypertension Triple therapy SVR Fibroscan® |
| title | Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy |
| title_full | Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy |
| title_fullStr | Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy |
| title_full_unstemmed | Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy |
| title_short | Influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic HCV patients treated with antiviral triple therapy |
| title_sort | influence of sustained viral response on the regression of fibrosis and portal hypertension in cirrhotic hcv patients treated with antiviral triple therapy |
| topic | Portal pressure gradient Portal hypertension Triple therapy SVR Fibroscan® |
| url | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082017000100004&lng=en&tlng=en |
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