Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Reiberger, T; Rutter, K; Ferlitsch, A; Payer, BA; Hofer, H; Beinhardt, S; Kundi, M; Ferenci, P; Gangl, A; Trauner, M; Peck-Radosavljevic, M.
Portal pressure predicts outcome and safety of antiviral therapy in cirrhotic patients with hepatitis C virus infection.
Clin Gastroenterol Hepatol. 2011; 9(7):602-608
Doi: 10.1016/j.cgh.2011.03.002
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Trauner Michael
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- Abstract:
- BACKGROUND & AIMS: There are limited data on the efficacy and safety of antiviral therapy in patients with hepatitis C virus (HCV)-related cirrhosis, particularly on the impact of portal hypertension. METHODS: We assessed hepatovenous pressure gradient (HVPG), liver stiffness (transient elastography), and interleukin (IL)-28B polymorphisms (rs12979860) in 90 cirrhotic patients with HCV infection (82% genotype 1 or 4) before antiviral therapy with pegylated interferon and ribavirin. Efficacy and safety were evaluated. RESULTS: Rates of sustained virologic response were significantly lower among patients with clinically significant portal hypertension (CSPH; HVPG >= 10 mm Hg; n = 50) than among patients without CSPH (HVPG >= 10 mm Hg; n = 40): 14% vs 51% (P = .0007). Seventy-nine percent and 83% of patients with CSPH and without CSPH, respectively, received more than 80% of planned dose (P = .647). The predictive value of HVPG (area under the curve [AUC], 0.743) was greater than that of liver stiffness (AUC, 0.647) or of baseline HCV RNA levels (AUC, 0.620). The IL-28B polymorphism was not associated significantly with a sustained virologic response. Multivariate analysis revealed that HVPG (odds ratio [OR], 14.3; P = .009), baseline HCV RNA levels (OR, 5.3; P = .019), and HCV genotype (OR, 6.5; P = .046) were independent risk factors for treatment failure. A trend toward higher incidence of anemia and neutropenia was observed for patients with CSPH. The incidence and grade of thrombocytopenia were significantly higher among patients with than without CSPH (94% vs 75%; P = .006). CONCLUSIONS: HVPG is an independent predictor of response to antiviral therapy, with better predictive value than liver stiffness, baseline HCV RNA levels, HCV genotype, or IL-28B polymorphism. The incidence and grade of thrombocytopenia during antiviral therapy are higher among patients with CSPH. In evaluating cirrhotic HCV patients for antiviral treatment, measurement of HVPG should be considered.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Antiviral Agents - administration and dosage Antiviral Agents - adverse effects
- Elasticity Imaging Techniques - methods
- Female -
- Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy
- Humans -
- Incidence -
- Interferon-alpha - administration and dosage Interferon-alpha - adverse effects
- Interleukins - genetics
- Liver - pathology
- Liver Cirrhosis - diagnosis Liver Cirrhosis - pathology
- Male -
- Middle Aged -
- Polyethylene Glycols - administration and dosage Polyethylene Glycols - adverse effects
- Polymorphism, Genetic -
- Portal Pressure - physiology
- Predictive Value of Tests -
- Prognosis -
- Recombinant Proteins -
- Ribavirin - administration and dosage Ribavirin - adverse effects
- Thrombocytopenia - chemically induced
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Liver Disease
- Fibrosis
- Portal Pressure
- Treatment Response