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Useful Predictor for Exacerbation of Esophagogastric Varices after Hepatitis C Virus Eradication by Direct-Acting Antivirals

Authors :
Yuko Nagaoki
Kenji Yamaoka
Yasutoshi Fujii
Shinsuke Uchikawa
Hatsue Fujino
Atsushi Ono
Eisuke Murakami
Tomokazu Kawaoka
Daiki Miki
Hiroshi Aikata
C. Nelson Hayes
Masataka Tsuge
Shiro Oka
Source :
Livers, Vol 4, Iss 3, Pp 352-363 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

To clarify the risk factors for the aggravation of esophagogastric varices (EGVs) 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, EGVs were 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 a platelet count < 11.0 × 104/μL, LSM ≥ 18.0 kPa, total bile acid ≥ 33.0 μmol/L, and a diameter of left gastric vein (LGV) ≥ 5.0 mm at HCV eradication as independent risk factors for EGV aggravation post-SVR. In groups that met 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. EGVs tend to worsen as two or more of these risk factors increase.

Details

Language :
English
ISSN :
26734389
Volume :
4
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Livers
Publication Type :
Academic Journal
Accession number :
edsdoj.9561c7e746144a2781c2f6ff47ab51b5
Document Type :
article
Full Text :
https://doi.org/10.3390/livers4030025