Patients with chronic hepatitis C who develop cirrhosis with severe portal hypertension are at greater risk of progressing to liver decompensation within the first 5 years of treatment, even if they show a sustained virologic response to therapy, a cohort study has found.
The study of 100 patients with hepatitis C and compensated cirrhosis showed that the probability of developing a first episode of liver decompensation at 1, 5, and 7 years was 4%, 25%, and 28%, respectively, among patients with an hepatic venous pressure gradient (HVPG) value of 10 mm Hg or above, compared with 0, 0, and 16% in patients without cirrhosis with severe portal hypertension (CSPH).
Courtesy NIH
Nearly three-quarters of the patients in the study had CSPH at baseline and 35% achieved a sustained virologic response, while 19% developed liver decompensation, according to Dr. Sabela Lens of the Institut d’Investigacions Biomèdiques August-Pi-Sunyer, Barcelona, and coauthors.
“Although viral clearance was associated with a significant reduction in HVPG, this effect, at least 24 weeks after the end of treatment, was mild and only one-third of patients with a high-risk baseline situation with CSPH shifted to a condition of low risk for developing liver decompensation,” they wrote (Clin Gastro Hepatol. 2015. doi: 10.1016/j.cgh.2015.04.013).
“The results of our study show that baseline HVPG value before antiviral treatment is a strong predictor of liver decompensation on follow-up evaluation,” Dr. Lens and associates noted.
The study was funded by the Instituto de Salud Carlos III, and one author was funded by an unrestricted grant from Roche. There were no other conflicts of interest declared.