Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension.

Afdhal, N; Everson, G T; Calleja, J L; McCaughan, G W; Bosch, Jaime; Brainard, D M; McHutchison, J G; De-Oertel, S; An, D; Charlton, M; Reddy, K R; Asselah, T; Gane, E; Curry, M P; Forns, X (2017). Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension. Journal of viral hepatitis, 24(10), pp. 823-831. Blackwell Science 10.1111/jvh.12706

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Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment. Secondary endpoints included changes in HVPG, laboratory parameters, and MELD and CPT scores. A subset of patients was followed 48 weeks posttreatment to determine late changes in HVPG. SVR12 occurred in 72% of patients (33/46). In the 37 patients with paired HVPG measurements at baseline and the end of treatment, mean HVPG decreased by -1.0 (SD 3.97) mm Hg. Nine patients (24%) had ≥20% decreases in HVPG during treatment. Among 39 patients with pretreatment HVPG ≥12 mm Hg, 27 (69%) achieved SVR12. Four of the 33 (12%) patients with baseline HVPG ≥12 mm Hg had HVPG <12 mm Hg at the end of treatment. Of nine patients with pretreatment HVPG ≥12 mm Hg who achieved SVR12 and completed 48 weeks of follow-up, eight (89%) had a ≥20% reduction in HVPG, and three reduced their pressure to <12 mm Hg. Patients with chronic HCV and compensated or decompensated cirrhosis who achieve SVR can have clinically meaningful reductions in HVPG at long-term follow-up. (EudraCT 2012-002457-29).

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

UniBE Contributor:

 Bosch, Jaime

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 1352-0504

Publisher:

 Blackwell Science

Language:

 English

Submitter:

 Thi Thao Anh Pham

Date Deposited:

 08 Mar 2018 15:11

Last Modified:

 02 Mar 2023 23:30

Publisher DOI:

 10.1111/jvh.12706

PubMed ID:

 28295923

Uncontrolled Keywords:

 advanced liver disease cirrhosis decompensated cirrhosis direct-acting antivirals hepatic venous pressure gradient portal hypertension

BORIS DOI:

 10.7892/boris.110899

URI:

 https://boris.unibe.ch/id/eprint/110899

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