Noninvasive testing may predict portal hypertension, clinical outcomes in cured HCV
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LONDON — Noninvasive testing may predict clinically significant portal hypertension and other outcomes in patients after hepatitis C virus cure, according to research presented at the International Liver Congress.
“The presence of clinically significant portal hypertension determines decision treatment with nonselective beta-blockers in compensated, advanced chronic liver disease,” Georg Semmler, MD, PhD, of the Medical University of Vienna, said. “It's important to know whether the patient has clinically significant portal hypertension or not. However, hepatic venous pressure gradient is not broadly available in a larger population. Therefore, we need noninvasive tests to diagnose potential.”
In an individual patient data meta-analysis, Semmler and colleagues analyzed 418 patients with pre-treatment hepatic venous pressure gradient (HVPG) of at least 6 mmHg who achieved a sustained virological response and underwent post-treatment HVPG.
Researchers further compared pre- and post-treatment liver stiffness measurement and platelet count and validated noninvasive criteria against direct endpoint hepatic decompensation in 470 patients with compensated advanced chronic liver disease who achieved sustained virological response.
At a median of 28.4 weeks after treatment, researchers evaluated data on 324 patients. According to study results, HVPG decreased in 79.7%of patients, increased in 14.8% and remained unchanged in 5.5% (median relative difference: –18.8). Researchers also reported HVPG decreases of greater than 10% among 64.2% of patients with pre-treatment CSPH (84.4%).
In patients with advanced chronic liver disease with paired noninvasive tests, there was a stronger correlation between liver stiffness and HVPG after treatment compared with before treatment (P < 0.001), while the correlation between platelet count and HVPG remained unchanged.
“Etiological cure modifies the relationship between noninvasive testing and HVPG,” Semmler concluded. “Noninvasive tests can estimate the probability but also be used to exclude or rule-in CSPH after HCV cure.”
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Semmler G, et al. Abstract OS127. Presented at: International Liver Congress; June 22-26, 2022; London (hybrid meeting).
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