Effect of sustained viral response on hepatic venous pressure gradient in hepatitis C-related cirrhosis.
OBJECTIVE
Interferon-based therapy can improve hepatic histology in chronic hepatitis C (CHC)-related cirrhosis but its effect on portal hypertension is unclear. The aims of this study were to investigate the effect of treatment with peginterferon alfa-2a and ribavirin on hepatic venous pressure gradient (HVPG) in CHC with compensated cirrhosis.


METHODS
Forty-seven patients with compensated biopsy examination-proven cirrhosis were recruited from 2 metropolitan teaching hospitals and were treated for 48 weeks with combination peginterferon alfa-2a 180 microg by subcutaneous injection weekly and ribavirin 800-1200 mg/day orally. A transjugular liver biopsy examination and HVPG measurement were performed at baseline, and 33 patients had a repeat HVPG measurement after 6 months of treatment-free follow-up evaluation.


RESULTS
The overall sustained viral response (SVR) was 21%. Posttreatment there was a significant decrease in HVPG level in sustained responders compared with nonresponders (-2.1 +/- 4.8 vs 0.6 +/- 2.8 mm Hg; P = .05). Among patients with portal hypertension, a higher proportion of sustained responders achieved a 20% or greater reduction in HVPG level compared with nonresponders (71% vs 20%; P = .01). There was a significant association between a 20% or greater reduction in HVPG and both histologic response and SVR.


CONCLUSIONS
Treatment with combination peginterferon plus ribavirin may produce clinically significant reductions in HVPG in patients with CHC-related cirrhosis who achieve an SVR.
Roberts
Stuart
S
Department of Gastroenterology, Alfred Hospital, Melbourne, Victoria, Australia. s.roberts@alfred.org.au
Gordon
Adam
A
McLean
Catriona
C
Pedersen
John
J
Bowden
Scott
S
Thomson
Kenneth
K
Angus
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D004279:DNA, Viral / Q000097:blood; D004337:Drug Carriers; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000503:physiopathology*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008102:Liver Circulation / Q000187:drug effects / Q000502:physiology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D014690:Venous Pressure / Q000187:drug effects / Q000502:physiology*; D019562:Viral Load; D014774:Virulence / Q000187:drug effects
D000998:Antiviral Agents; D004279:DNA, Viral; D004337:Drug Carriers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a