Portal pressure reduction after entecavir treatment in compensated HBV cirrhosis.
A Caucasian male aged 54 year was referred to our liver centre for the management of HBV-related cirrhosis. Prior treatment with recombinant alpha-interferon followed by lymphoblastoid interferon was only temporarily effective and the patient refused antiviral treatment with lamivudine. When admitted to our unit, the patient had a Child-Pugh score of A6, high HBV DNA load (4 x 10(6) IU/ml) and evidence of cirrhotic cardiomyopathy. Hepatic venous pressure gradient (HVPG) was 29mm Hg, indicative of clinically severe portal hypertension. Following 3 months of treatment with entecavir, tests for HBV DNA were negative, and 9 months after therapy started, HVPG was measured as 24mm Hg, a reduction from baseline of 17%. These findings indicate that sustained suppression of HBV DNA replication by entecavir in compensated cirrhosis with severe portal hypertension leads to a portal pressure reduction, without the need for vaso-active drugs, as measured using the transjugular HVPG approach described here.
Pozzi
Massimo
M
Centro Epatologia, Clinica Medica AO San Gerardo (Monza), Università degli Studi Milano-Bicocca, Italy. epa.monza@libero.it
Pizzala
Daniela Prata
DP
Maldini
Francesco Fumagalli
FF
Doretti
Alberto
A
Ratti
Laura
L
D000998:Antiviral Agents / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000503:physiopathology* / Q000821:virology*; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents; C413685:entecavir; D006147:Guanine