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Aminopyrine breath test predicts liver-related events and death in HCV-related cirrhosis on SVR after DAA therapy
- Publication Year :
- 2019
- Publisher :
- Blackwell Publishing Ltd, 2019.
-
Abstract
- Background & Aims: In patients with hepatitis C virus (HCV)-related advanced cirrhosis, the effects of sustained virological response (SVR) by direct antiviral agents (DAAs) on decompensation and liver deaths are less clearcut, since up to 30% of patients do not improve, and no predictors of outcome have been identified. We used 13C-aminopyrine breath test (ABT) to assess whether its changes can predict liver-related outcomes after DAA treatment in patients with HCV cirrhosis. Methods: Fifty consecutive patients with HCV cirrhosis were enrolled. Patients were included if they had Child A cirrhosis at risk for decompensation – defined as Child A6 (N=22, 44%) or previous decompensation (N=7, 14%) – or Child B cirrhosis (N=21, 42%) eligible for DAA-based antiviral therapy. ABT was performed at baseline and 12weeks after the end of antiviral therapy. Patients received sofosbuvir-based regimens. Results: Aminopyrine breath test was available for all 50 patients at baseline. The 120’ cumulative dose was directly associated at regression analysis only with albumin levels (P=.001). ABT was available at follow-up week 12 for 41 patients (FUW12), all with SVR, and followed for a median of 25.2months (range 12.2-32.1months). Lower Ʌ ABT – defined as changes of 120’ cumulative dose from FUW12 to baseline – (HR 0.97, 95% CI 0.94-0.99; P=.02) and FUW12 hepatic encephalopathy (HR 19.0, 95% CI 1.16-310.3; P=.03) were the only independent predictors of liver events/death at multivariate Cox regression analysis. The AUC of Ʌ ABT was good (0.87, 95% CI 0.75-0.97), with a delta ≥0% well discriminating patients at lower vs patients at higher risk of liver-related events/death (P&nbsp
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Cirrhosis
Sofosbuvir
Hepatitis C virus
Hepacivirus
medicine.disease_cause
Antiviral Agents
Gastroenterology
Internal medicine
Humans
Medicine
Decompensation
Aminopyrine
Child
CIRRHOSIS
Hepatic encephalopathy
aminopyrine breath test
Breath test
Hepatology
medicine.diagnostic_test
direct antiviral agent
Cumulative dose
business.industry
Hepatitis C, Chronic
medicine.disease
Hepatitis C
Breath Tests
liver function
Liver function
business
DIRECT ANTIVIRAL AGENTS
AMINOPYRINE BREATH TEST
LIVER FUNCTION
medicine.drug
cirrhosi
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....9c8163ae1f55a72069a59ab3178323cb