Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals
The advent of direct antiviral agents (DAAs) has radically changed the natural history of hepatitis C virus (HCV) chronic liver disease. Even patients with cirrhosis may display improvements in liver function or features of portal hypertension following viral eradication. The aim of this study was t...
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MDPI AG
2022-08-01
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| Online Access: | https://www.mdpi.com/2079-7737/11/8/1160 |
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| author | Angelo Armandi Chiara Rosso Giulia Troshina Nuria Pérez Diaz Del Campo Chiara Marinoni Aurora Nicolosi Gian Paolo Caviglia Giorgio Maria Saracco Elisabetta Bugianesi Alessia Ciancio |
| author_facet | Angelo Armandi Chiara Rosso Giulia Troshina Nuria Pérez Diaz Del Campo Chiara Marinoni Aurora Nicolosi Gian Paolo Caviglia Giorgio Maria Saracco Elisabetta Bugianesi Alessia Ciancio |
| author_sort | Angelo Armandi |
| collection | DOAJ |
| description | The advent of direct antiviral agents (DAAs) has radically changed the natural history of hepatitis C virus (HCV) chronic liver disease. Even patients with cirrhosis may display improvements in liver function or features of portal hypertension following viral eradication. The aim of this study was to assess whether a HCV cure would lead to improvements in cirrhotic patients using simple, readily available tools in clinical practice, together with liver stiffness (LS) measurement. This is a retrospective study of cirrhotic patients with cured HCV infection, with or without previous decompensation. Clinical and biochemical parameters as well as LS measurements were collected before antiviral treatment with DAAs and after 6 months following sustained virological response. Hepatic synthesis was assessed by serum albumin levels. Portal hypertension was indirectly assessed by platelet count. Liver function was determined by the CHILD score. A total of 373 cirrhotic patients with successful HCV eradication were retrospectively included. After 6 months of follow-up, a significantly higher proportion of patients showed improved liver function, shifting from the CHILD B/C to CHILD A group, (71.4%, <i>p</i> < 0.001). Similarly, LS improved from a median of 19.3 kPa (14.7–27) at the baseline vs. a median of 11.6 (7.7–16.8 kPa) at follow-up (<i>p</i> < 0.001). The proportion of patients who showed improved hepatic synthesis was 66.0%, which was statistically different when compared to that of patients who had a worsened condition (0.3%) (<i>p</i> < 0.001). Moreover, when classifying the cohort according to the RESIST-HCV score, we found that a significant proportion of patients shifted into the “low risk” group following DAA treatment (52% baseline vs. 45.6% at follow-up, <i>p</i> = 0.004). Even in the decompensated patients, LS improved from 1.6 to 2-fold from the baseline. Antiviral treatment is effective in improving indirect signs of hepatic synthesis and portal hypertension. Similarly, the LS values displayed significant improvements, even in decompensated patients. |
| first_indexed | 2024-03-09T11:52:59Z |
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| institution | Directory Open Access Journal |
| issn | 2079-7737 |
| language | English |
| last_indexed | 2024-03-09T11:52:59Z |
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| spelling | doaj.art-f3c93cfdc3b24bf58bed690e8a6b74fe2023-11-30T23:13:13ZengMDPI AGBiology2079-77372022-08-01118116010.3390/biology11081160Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic IndividualsAngelo Armandi0Chiara Rosso1Giulia Troshina2Nuria Pérez Diaz Del Campo3Chiara Marinoni4Aurora Nicolosi5Gian Paolo Caviglia6Giorgio Maria Saracco7Elisabetta Bugianesi8Alessia Ciancio9Department of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyDepartment of Medical Sciences, University of Turin, 10126 Turin, ItalyThe advent of direct antiviral agents (DAAs) has radically changed the natural history of hepatitis C virus (HCV) chronic liver disease. Even patients with cirrhosis may display improvements in liver function or features of portal hypertension following viral eradication. The aim of this study was to assess whether a HCV cure would lead to improvements in cirrhotic patients using simple, readily available tools in clinical practice, together with liver stiffness (LS) measurement. This is a retrospective study of cirrhotic patients with cured HCV infection, with or without previous decompensation. Clinical and biochemical parameters as well as LS measurements were collected before antiviral treatment with DAAs and after 6 months following sustained virological response. Hepatic synthesis was assessed by serum albumin levels. Portal hypertension was indirectly assessed by platelet count. Liver function was determined by the CHILD score. A total of 373 cirrhotic patients with successful HCV eradication were retrospectively included. After 6 months of follow-up, a significantly higher proportion of patients showed improved liver function, shifting from the CHILD B/C to CHILD A group, (71.4%, <i>p</i> < 0.001). Similarly, LS improved from a median of 19.3 kPa (14.7–27) at the baseline vs. a median of 11.6 (7.7–16.8 kPa) at follow-up (<i>p</i> < 0.001). The proportion of patients who showed improved hepatic synthesis was 66.0%, which was statistically different when compared to that of patients who had a worsened condition (0.3%) (<i>p</i> < 0.001). Moreover, when classifying the cohort according to the RESIST-HCV score, we found that a significant proportion of patients shifted into the “low risk” group following DAA treatment (52% baseline vs. 45.6% at follow-up, <i>p</i> = 0.004). Even in the decompensated patients, LS improved from 1.6 to 2-fold from the baseline. Antiviral treatment is effective in improving indirect signs of hepatic synthesis and portal hypertension. Similarly, the LS values displayed significant improvements, even in decompensated patients.https://www.mdpi.com/2079-7737/11/8/1160hepatitis C virusdirect antiviral agentshepatic fibrosisliver stiffnessportal hypertensioncirrhosis |
| spellingShingle | Angelo Armandi Chiara Rosso Giulia Troshina Nuria Pérez Diaz Del Campo Chiara Marinoni Aurora Nicolosi Gian Paolo Caviglia Giorgio Maria Saracco Elisabetta Bugianesi Alessia Ciancio Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals Biology hepatitis C virus direct antiviral agents hepatic fibrosis liver stiffness portal hypertension cirrhosis |
| title | Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals |
| title_full | Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals |
| title_fullStr | Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals |
| title_full_unstemmed | Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals |
| title_short | Changes in Liver Stiffness and Markers of Liver Synthesis and Portal Hypertension following Hepatitis C Virus Eradication in Cirrhotic Individuals |
| title_sort | changes in liver stiffness and markers of liver synthesis and portal hypertension following hepatitis c virus eradication in cirrhotic individuals |
| topic | hepatitis C virus direct antiviral agents hepatic fibrosis liver stiffness portal hypertension cirrhosis |
| url | https://www.mdpi.com/2079-7737/11/8/1160 |
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