Nagaoki, Y.; Yamaoka, K.; Fujii, Y.; Uchikawa, S.; Fujino, H.; Ono, A.; Murakami, E.; Kawaoka, T.; Miki, D.; Aikata, H.; Hayes, C.N.; Tsuge, M.; Oka, S. Useful Predictor for Exacerbation of Esophagogastric Varices after Hepatitis C Virus Eradication by Direct-Acting Antivirals. Livers2024, 4, 352-363.
Nagaoki, Y.; Yamaoka, K.; Fujii, Y.; Uchikawa, S.; Fujino, H.; Ono, A.; Murakami, E.; Kawaoka, T.; Miki, D.; Aikata, H.; Hayes, C.N.; Tsuge, M.; Oka, S. Useful Predictor for Exacerbation of Esophagogastric Varices after Hepatitis C Virus Eradication by Direct-Acting Antivirals. Livers 2024, 4, 352-363.
Nagaoki, Y.; Yamaoka, K.; Fujii, Y.; Uchikawa, S.; Fujino, H.; Ono, A.; Murakami, E.; Kawaoka, T.; Miki, D.; Aikata, H.; Hayes, C.N.; Tsuge, M.; Oka, S. Useful Predictor for Exacerbation of Esophagogastric Varices after Hepatitis C Virus Eradication by Direct-Acting Antivirals. Livers2024, 4, 352-363.
Nagaoki, Y.; Yamaoka, K.; Fujii, Y.; Uchikawa, S.; Fujino, H.; Ono, A.; Murakami, E.; Kawaoka, T.; Miki, D.; Aikata, H.; Hayes, C.N.; Tsuge, M.; Oka, S. Useful Predictor for Exacerbation of Esophagogastric Varices after Hepatitis C Virus Eradication by Direct-Acting Antivirals. Livers 2024, 4, 352-363.
Abstract
To clarify the risk factors for aggravation of esophagogastric varices (EGV) after hepatitis C virus (HCV) eradication with direct-acting antiviral (DAA) therapy, we enrolled 167 consecutive patients with HCV-related compensated cirrhosis who achieved a sustained virological response (SVR) after DAA therapy. During a median of 69 months, EGV was aggravated in 42 (25%) patients despite SVR. The cumulative 1, 3, 5, and 10-year aggravated EGV rates were 7%, 23%, 25%, and 27%, respectively. Multivariate analysis identified platelet count <11.0×104/μL, LSM ≥18.0 kPa, total bile acid ≥33.0 μmol/L, and diameter of left gastric vein (LGV) ≥5.0 mm at HCV eradication as independent risk factors for EGV aggravation post-SVR. In groups that meet all of these risks, the cumulative EGV aggravation rates at 1, 3, and 5 years were 27%, 87%, and 91%, respectively. However, none of the patients who had only one or none of the risk factors experienced EGV aggravation. Platelet count, LSM, total bile acid, and diameter of LGV at HCV eradication were associated with aggravated EGV post-SVR. EGV tends to worsen as two or more of these risk factors increase.
Keywords
Direct-acting antiviral; sustained virological response; esophagogastric varices; liver stiffness measurement; total bile acid; left gastric vein
Subject
Medicine and Pharmacology, Gastroenterology and Hepatology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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