Course of oesophageal varices and performance of noninvasive predictors following Hepatitis C Virus clearance in compensated advanced chronic liver disease
Corresponding Author
Edoardo G. Giannini
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Correspondence
Edoardo G. Giannini, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, no.6, Genoa 16132, Italy.
Email: [email protected]
Search for more papers by this authorCostanza De Maria
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorMattia Crespi
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorMaria Giulia Demarzo
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorValentina Fazio
Gastroenterology Unit, Department of Internal Medicine, San Paolo Hospital, Savona, Italy
Search for more papers by this authorAlessandro Grasso
Gastroenterology Unit, Department of Internal Medicine, San Paolo Hospital, Savona, Italy
Search for more papers by this authorFrancesco Torre
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorGiorgia Bodini
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorElisa Marabotto
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorManuele Furnari
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorCorresponding Author
Edoardo G. Giannini
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Correspondence
Edoardo G. Giannini, Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Viale Benedetto XV, no.6, Genoa 16132, Italy.
Email: [email protected]
Search for more papers by this authorCostanza De Maria
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorMattia Crespi
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorMaria Giulia Demarzo
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorValentina Fazio
Gastroenterology Unit, Department of Internal Medicine, San Paolo Hospital, Savona, Italy
Search for more papers by this authorAlessandro Grasso
Gastroenterology Unit, Department of Internal Medicine, San Paolo Hospital, Savona, Italy
Search for more papers by this authorFrancesco Torre
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorGiorgia Bodini
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorElisa Marabotto
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorManuele Furnari
Gastroenterology Unit, Department of Internal Medicine, IRCCS–Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
Search for more papers by this authorAbstract
Background
In patients with hepatitis C virus (HCV) and compensated advanced chronic liver disease (cACLD), there is evidence that sustained virological response (SVR) to direct-acting antivirals (DAA) may ameliorate portal hypertension, although both the course of oesophageal varices and the performance of their noninvasive predictors following DAA-induced SVR are less defined. In this study, our aim was to assess the variation in oesophageal varices status in HCV patients with cACLD who obtained an SVR to DAAs and to evaluate the diagnostic performance of noninvasive predictors of varices after HCV cure.
Material and methods
Sixty-three HCV patients with cACLD and SVR to DAAs were prospectively followed up, and oesophageal varices surveillance was carried out according to the Baveno VI indications. Appearance and disappearance of varices, accuracy performance of their noninvasive predictors (Baveno/expanded Baveno VI criteria, platelet count/spleen diameter ratio) and number of endoscopies spared with their application were calculated.
Results
Following SVR, varices developed or disappeared in 12.1% and 17.4% of patients, respectively. The negative predictive value for varices of the Baveno VI, expanded Baveno VI criteria and platelet count/spleen diameter ratio following SVR was 88.2% (65.6-96.7), 83.3% (66.3-92.7) and 80.7% (67.1-89.5), respectively. Their application would have saved 30.4%, 42.9% and 55.4% of endoscopies, with no varices needing treatment missed using both Baveno VI criteria.
Conclusions
In HCV patients with cACLD, following SVR to DAA, the expanded Baveno VI criteria provide the best balance between utility (diagnostic accuracy and endoscopies avoided) and safety (varices needing treatment missed) for varices surveillance.
CONFLICT OF INTEREST
None.
Supporting Information
| Filename | Description |
|---|---|
| eci13231-sup-0001-TableS1-S2.docxWord document, 25.7 KB | Table S1-S2 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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