Clinical outcome and hemodynamic changes following HCV eradication with oral antiviral therapy in patients with clinically significant portal hypertension

Lens, Sabela; Baiges, Anna; Alvarado‐Tapias, Edilmar; Llop, Elba; Martínez, Javier; Fortea, José Ignacio; Ibáñez‐Samaniego, Luis; Mariñó, Zoe; Rodríguez‐Tajes, Sergio; Gallego, Adolfo; Bañares, Rafael; Puente, Ángela; Albillos, Agustı́n; Calleja, José Luís; Torras, Xavier; Hernández‐Gea, Virginia; Bosch, Jaume; Villanueva, Càndid; García-Pagán, Juan Carlos; Forns, Xavier

doi:10.1016/j.jhep.2020.05.050

Cited by 133 publications

(126 citation statements)

References 23 publications

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“…In our study, we found that the AUROC value of LSM was only 0.691, which might because of the fact that patients with mild varices still have a high value of LSM. Similar to our results, other studies also questioned the discriminative ability of LSM to rule out CSPH in HCV patients after viral clearance, especially in patients with regression of portal hypertension 17,25 …”

Section: Discussionsupporting

confidence: 85%

Screening varices in patients with HBV‐related cirrhosis on antiviral therapy: Platelet alone or together with LSM

Wang

Zhou

et al. 2020

Liver International

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Background & Aims Non‐invasive assessment criteria to rule out high‐risk varices (HRV) in compensated hepatitis B virus (HBV) cirrhosis on antiviral therapy remains unclear. Methods HBV‐related compensated cirrhotic patients who underwent screening endoscopy during antiviral therapy were enrolled and randomly divided into the derivation and validation sets. HRV were defined as medium to large varices or small varices with red signs. Univariate and multivariate logistic analysis were used to determine the parameters associated with HRV. Results A total of 436 HBV‐related compensated cirrhotic patients screened for varices were enrolled, the median duration of antiviral therapy was 4 years (IQR: 2.5‐5.5 years). In the derivation set (N = 290, 17.2% with HRV), only platelet (PLT) count (OR = 0.972, 95% CI 0.961‐0.984, P < .05) was independently associated with HRV, whereas liver stiffness measurement was not associated with the presence of HRV. With a PLT count cut‐off value of 105 × 109/L, unnecessary endoscopies could be spared in 56.9% patients, with a 3.6%. risk of missing HRV. In the validation cohort (N = 146, 16.4% with HRV), the proportion of patients that could safely spare endoscopies (61.0%) identified by this PLT count cut‐off value was higher than that obtained by using Baveno VI criteria (34.9%), with an acceptable risk of missing HRV (3.4%). Conclusion Compared with the ‘Baveno VI criteria or beyond’ criteria, PLT count higher than 105 × 109/L could safely spare more screening endoscopies without increasing the risk of missing HRV in patients with HBV‐related compensated cirrhosis on antiviral therapy.

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Section: Discussionsupporting

confidence: 85%

Screening varices in patients with HBV‐related cirrhosis on antiviral therapy: Platelet alone or together with LSM

Wang

Zhou

et al. 2020

Liver International

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“…Thus, we believe that this lower rate of SVR should be associated with a lower rate of improvement of cirrhosis complications in HCC patients than in patients without HCC. Supplementary Table 1 summarizes the publications [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] on the benefits of DAAs in patients with portal hypertension, liver decompensation, and fibrosis regression, as well as the rate of HCC patients included in the above-cited studies, wherein the number of HCC patients was limited.…”

Section: Current Data On Daa Treatment In Patients With Compensated Omentioning

confidence: 99%

“…It is already known that HCC patients are at a risk of developing cirrhosis-related complications, and the results from Lens's [11] and Verna's [23] studies provide a reference for establishing the potential benefits of DAAs in the HCC population. Additionally, Belli et al [28] reported a significantly lower probability of liver transplantation (LT) linked to the improvement in liver function in patients treated with DAAs than in those not treated with DAA.…”

Section: Current Data On Daa Treatment In Patients With Compensated Omentioning

confidence: 99%

Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)

Reig

Cabibbo

2021

Journal of Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…In Summe wiesen 63 % der PatientInnen mit CSPH einen klinisch relevanten HVPG-Abfall von ≥10 % auf [22]. Obwohl ein klinisch relevanter HVPG-Abfall auch in einer Arbeit von Lens et al [23] in 62% bestätigt werden konnte, blieb bei 78 % der PatientInnen trotz SVR die CSPH bestehen, die in einer rezent veröffentlichten Folgearbeit bei 53-65 % der PatientInnen auch 96 Wochen nach Therapieende persistierte [24]. Diese Ergebnisse verdeutlichen, dass bei einem relevanten Anteil der PatientInnen mit fortgeschrittener Lebererkrankung trotz SVR keine bedeutende Regression bzw.…”

Section: Verbesserung Der Laborparameterunclassified

“…ausschließen kann, wobei bei isolierter Anwendung dieses NIT ein hoher Anteil an nichtklassifizierbaren PatientInnen ("Grauzone") verbleibt. Die alleinige Anwendung der LSM weist, wie in den Arbeiten von Lens et al [23,24] in einem Kollektiv mit noch weiter fortgeschrittener Lebererkrankung sowohl für 24 als auch 96 Wochen nach Therapieende gezeigt, eine für die klinische Anwendung ungenügende Genauigkeit/Trennschärfe in der Diagnostik der CSPH auf. Eine weitere Publikation unserer Arbeitsgruppe [15] konnte bestätigen, dass die Ratio aus VWF und Thrombozytenzahl (i.e.…”

Section: Verbesserung Der Laborparameterunclassified

Nachbetreuung von PatientInnen mit „sustained virologic response“

Semmler

Mandorfer

2020

J. Gastroenterol. Hepatol. Erkr.

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ZusammenfassungDa die Therapie der chronischen Hepatitis C aufgrund der neuen direkt antiviral wirkenden Therapeutika („direct-acting antivirals“, DAA) aus virologischer Sicht bei nahezu allen PatientInnen zur nachhaltigen Ausheilung („sustained virologic response“, SVR) der Infektion führt, hat sich das Hauptaugenmerk auf Eliminationsprojekte sowie die Nachsorge von PatientInnen mit ausgeheilter Hepatitis-C-Infektion verschoben. In diesem Übersichtsartikel werden rezente Studien und Empfehlungen zum Thema Nachsorge nach HCV-Eradikation zusammengefasst, um den LeserInnen einen Leitfaden für die klinische Praxis zur Verfügung zu stellen.

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Clinical outcome and hemodynamic changes following HCV eradication with oral antiviral therapy in patients with clinically significant portal hypertension

Cited by 133 publications

References 23 publications

Screening varices in patients with HBV‐related cirrhosis on antiviral therapy: Platelet alone or together with LSM

Screening varices in patients with HBV‐related cirrhosis on antiviral therapy: Platelet alone or together with LSM

Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)

Nachbetreuung von PatientInnen mit „sustained virologic response“

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