Antiviral therapy decreases hepatic venous pressure gradient in patients with ch

October 18, 2006

1: Am J Gastroenterol. 2006 Oct;101(10):2269-74.

Antiviral therapy decreases hepatic venous pressure gradient in patients

with chronic hepatitis C and advanced fibrosis.

Rincon D, Ripoll C, Iacono OL, Salcedo M, Catalina MV, Alvarez E, Nunez O,

Matilla AM, Clemente G, Banares R.

Liver and Transplant Unit, Hospital General Universitario Gregorio Maranon,

Madrid, Spain.

BACKGROUNDS: Antiviral therapy (AVT) may improve liver histology in patients

with advanced viral hepatitis but its effect on portal pressure remains

unknown. AIM: This study was aimed to evaluate the influence of antiviral

therapy (AVT) on hepatic venous pressure gradient (HVPG) in hepatitis C

virus infected patients with portal hypertension. METHODS: Twenty

compensated patients with chronic hepatitis C, fibrosis stage 3 or 4 and

HVPG > 5 mmHg received PEG-IFN alpha2b plus ribavirin. Every patient

underwent liver biopsy and portal pressure measurements before and

immediately after AT. Biopsies were evaluated according to METAVIR score.

RESULTS: HVPG significantly dropped in all but one treated patient, with a

mean (SD) reduction of 28.2 (12)%[13.8 (5.6) Vs. 10.2 (3.8) mmHg, p =

0.005]. The percentage of HVPG decrease was significantly greater in

patients who achieved a virological end of treatment response [26.2 (12.5)%

Vs. 12.7 (8.5)%, p = 0.05] and in those with a decrease of at least 2 points

in the grade of inflammation [35.7 (4.5)% Vs. 22.1 (9.5)%, p = 0.015]. Nine

out of 11 patients with baseline HVPG >/= 12 mmHg showed a decrease greater

than 20% (3/11) or under the 12 mmHg threshold (6/11). CONCLUSIONS: AVT

reduces HVPG in compensated patients with advanced hepatitis C (fibrosis

stage 3 or 4) and portal hypertension.

PMID: 17032192 [PubMed - in process]

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October 18, 2006