The course of esophageal varices in patients with hepatitis C cirrhosis responding to interferon/ribavirin therapy

Roberta D'Ambrosio, Alessio Aghemo, Maria Grazia Rumi, Massimo Primignani, Alessandra Dell'Era, Pietro Lampertico, Maria Francesca Donato, Stella De Nicola, Gian Maria Prati, Roberto De Franchis, Massimo Colombo

Research output: Contribution to journalArticle

Abstract

Background: Gastrointestinal haemorrhage from ruptured esophageal varices (EV) is a significant cause of morbidity and mortality in patients with HCV-related cirrhosis. The risk of developing EV and bleeding is influenced by hepatitis severity, which can be attenuated by successful interferon (IFN) therapy. Our aim was to prospectively assess whether a successful IFN therapy modifies development and/or progression of EV in patients with HCVrelated compensated cirrhosis. Methods: Child-Pugh A patients with either no or small (F1) EV underwent surveillance with repeated endoscopy during and after completion of IFN-based therapy. Results: A total of 127 patients (59 years, 79 males, 65 HCV-1/4 and 17 F1 EV) received weight-based ribavirin (RBV) combined with either IFN-&αλπηα;2b 3 MU three times per week (n=36), weekly pegylated (PEG)-IFN-&αλπηα;2b 1.5 &μυ;g/kg (n=68) or weekly PEG-IFN- &αλπηα;2a 180 &μυ;g (n=23). Patients were followed-up for 18-108 months after treatment completion with a median endoscopic follow-up of 68 months for the 62 patients with a sustained virological response (SVR) and 57 months for the 65 non-SVR patients (P=0.3). De novo EV developed in 10 (9.1%) patients including 2/57 SVR and 8/53 non-SVR (3.5% versus 15.1%; P=0.047), whereas EV progressed in size in 3 patients, including 1/5 SVR and 2/12 non-SVR (P=0.87). Two non-SVR patients bled from EV and one died. Conclusions: A successful IFN therapy prevents or delays the de novo onset of EV in patients with compensated cirrhosis due to HCV, but does not abrogate the need for continued endoscopic surveillance.

Original languageEnglish
Pages (from-to)677-684
Number of pages8
JournalAntiviral Therapy
Volume16
Issue number5
DOIs
Publication statusPublished - 2011

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ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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