1. Spleen stiffness mirrors changes in portal hypertension after successful interferon-free therapy in chronic-hepatitis C virus patients
- Author
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Luigina Vanessa Alemanni, Davide Festi, Antonio Colecchia, Francesco Azzaroli, Mariarosa Tamè, Giovanni Marasco, Giuseppe Mazzella, Stefano Brillanti, Federico Ravaioli, Elton Dajti, Ravaioli, Federico, Colecchia, Antonio, Dajti, Elton, Marasco, Giovanni, Alemanni, Luigina Vanessa, Tamè, Mariarosa, Azzaroli, Francesco, Brillanti, Stefano, Mazzella, Giuseppe, and Festi, Davide
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,animal structures ,Spleen ,Direct-acting antiviral ,Direct-acting antivirals ,Gastroenterology ,Virus ,Spleen stiffness measurement ,03 medical and health sciences ,0302 clinical medicine ,Chronic hepatitis ,Internal medicine ,medicine ,Retrospective Cohort Study ,Advanced chronic liver disease ,Clinically significant portal hypertension ,Hepatitis C ,Non-invasive test ,Portal hypertension ,Hepatology ,skin and connective tissue diseases ,business.industry ,Interferon free ,equipment and supplies ,medicine.disease ,medicine.anatomical_structure ,Non invasive test ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,sense organs ,business - Abstract
AIM To investigate changes in spleen stiffness measurements (SSMs) and other non-invasive tests (NITs) after treatment with direct-acting antivirals (DAAs) and identify predictors of SSM change after sustained virological response (SVR). METHODS We retrospectively analysed 146 advanced-chronic liver disease (ACLD) patients treated with DAA with available paired SSM at baseline and SVR24. Liver stiffness (LSM), spleen diameter (SD), platelet count (PLT) and liver stiffness-spleen diameter to platelet ratio score(LSPS) were also investigated. LSM ≥ 21 kPa was used as a cut-off to rule-in clinically significant portal hypertension (CSPH). SSM reduction > 20% from baseline was defined as significant. RESULTS SSM significantly decreased at SVR24, in both patients with and without CSPH; in 44.8% of cases, SSM reduction was > 20%. LSPS significantly improved in the entire cohort at SVR24; SD and PLT changed significantly only in patients without CSPH. LSM significantly decreased in 65.7% of patients and also in 2/3 patients in whom SSM did not decrease. The independent predictor of decreased SSM was median relative change of LSM. CSPH persisted in 54.4% patients after SVR. Delta LSM and baseline SSM were independent factors associated with CSPH persistence. CONCLUSION SSM and other NITs significantly decrease after SVR, although differently according to the patient’s clinical condition. SSM faithfully reflects changes in portal hypertension and could represent a useful NIT for the follow-up of these patients.
- Published
- 2018