Liver Remodeling on CT Examination in Patients with HCV Compensated Cirrhosis Who Achieved Sustained Virological Response after Direct-Acting Antivirals Treatment

Abstract

Aims: The purpose of this study was to assess the changes in hepatic morphology evaluated by computed tomography (CT) examination in patients with hepatitis C virus (HCV)-related compensated cirrhosis who achieved sustained virologic response (SVR) after direct-acting antivirals (DAAs) treatment. Methods: CT examination was performed in 56 patients with HCV-related compensated cirrhosis before and within 6–18 months after the treatment with Ombitasvir/Paritaprevir/ritonavir + Dasabuvir. The liver CT changes were assessed by measuring liver volume, caudate-right lobe ratio (C/RL), hepatic vessels diameters, periportal widening space, and right posterior notch. Portal trunk, splenic and superior mesenteric vein diameters, as well as spleen volume were assessed as part of portal hypertension. Results: Right hepatic vein diameter was significantly wider after treatment (median: 8.12 mm; IQR: 4.20) than before treatment (median: 6.36 mm; IQR: 3.94) z = −3.894; p < 0.001. The liver volume was significantly higher prior to the treatment (median: 1786.77 mm3; IQR: 879.23) than after treatment (median: 1716.44 mm3; IQR: 840.50), z = −1.970; p = 0.049. Splenic volume was considerably higher before treatment (median: 564.79 mm3; IQR: 342.54) than after (median: 474.45 mm3; IQR: 330.00), z = −2.500; p = 0.012. The other parameters, such as C/RL, periportal space widening, and right hepatic notch showed no significant changes. Conclusions: SVR in patients with HCV-related compensated cirrhosis treated with DAAs is associated with some improvements of hepatic morphology detectable by CT, the most constant being the increase of right hepatic vein diameter.

Impact of sustained virologic response in regression of portal hypertension in Egyptian patients with hepatitis C virus-associated cirrhosis and portal hypertension

“…In our results, portal vein diameter showed 82.50% sensitivity and 95% specificity at cutoff value (> 13.8 mm), to predict the presence of CSPH in HCV-related liver cirrhosis, while showed 50% sensitivity and 100% specificity, at cutoff value (≤ 14 mm), to predict reversibility of CSPH. These findings are similar to Hagen-Ansert [ 27 ], who reported that a diameter (> 13 mm) was considered as a predictor of PH in patients with cirrhosis, but unlike Mahmoud et al [ 26 ] and Mihai et al [ 28 ], as their results were insignificant regarding PVD.…”

Genetic polymorphisms related to the vitamin D pathway in patients with cirrhosis with or without hepatocellular carcinoma (HCC)

“…Cirrhosis, the tenth leading cause of death in the world [ 1 ], is an irreversible chronic liver disease characterised by fibrosis, several structural liver lesions [ 2 ] and the formation of regenerative nodules [ 3 ], whose prevalence is underestimated in asymptomatic patients [ 4 ].…”

“…Cirrhosis, the tenth leading cause of death in the world [1], is an irreversible chronic liver disease characterised by fibrosis, several structural liver lesions [2] and the formation of regenerative nodules [3], whose prevalence is underestimated in asymptomatic patients [4].Cirrhosis is directly associated with the development of hepatocellular carcinoma (HCC) [2], present in 90% of the cases of this tumour type [5]. HCC represents the main primary liver neoplasia [6], being the second most common cause of cancer-related deaths [6] in the world, with 905,677 cases per year [7].…”