Serum albumin and platelet count but not portal pressure are predictive of death in patients with Child-Pugh A hepatitis C virus-related cirrhosis.
OBJECTIVE
The presence of esophageal varices has been reported to be a prognostic factor in patients with compensated hepatitis viral C induced cirrhosis. We studied the prognostic value of hepatic venous pressure gradient in addition to epidemiological and clinical parameters in these patients.


METHODS
Among patients with Child-Pugh A hepatitis C induced cirrhosis, prospectively followed in two Parisian centres, 100 had measurement of occluded and free hepatic venous pressures. We evaluated hepatic venous pressures as a predictive factor of death by Cox models (survival) and Fine and Gray models (liver-deaths).


RESULTS
Median hepatic occluded pressure and gradient were 21.5 (15-24) and 13 mm Hg (9-15), respectively. The median duration of follow-up was 85 months (range: 70-112); 38 deaths or liver transplantation were registered. Hepatic venous pressure gradient was not significantly related to survival in the studied population but as a continuous variable was predictive of death from liver disease. On multivariable analysis serum albumin <40 g/L and platelet count <90,000 /mm(3) were the only selected prognostic factors.


CONCLUSIONS
Hepatic venous pressure gradient has a limited value for assessing the prognosis of patients with Child-Pugh A hepatitis C virus induced cirrhosis; prognosis is accurately predicted by serum albumin and platelet count.
Nahon
Pierre
P
Service d'Hépato-gastroentérologie, Hôpital Jean Verdier, Assistance Publique, Hôpitaux de Paris, Bondy, France. pierre.nahon@jvr.ap-hop-paris.fr
Ganne-Carrié
Nathalie
N
Degos
Françoise
F
Nahon
Karine
K
Paries
Jacques
J
Grando
Véronique
V
Chaffaut
Cendrine
C
Njapoum
Corinne
C
Christidis
Christos
C
Trinchet
Jean-Claude
JC
Chevret
Sylvie
S
Beaugrand
Michel
M
D000368:Aged; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D017082:Portal Pressure; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis*; D016019:Survival Analysis
D012709:Serum Albumin