TY - JOUR
T1 - The course of esophageal varices in patients with hepatitis C cirrhosis responding to interferon/ribavirin therapy
AU - D'Ambrosio, Roberta
AU - Aghemo, Alessio
AU - Rumi, Maria Grazia
AU - Primignani, Massimo
AU - Dell'Era, Alessandra
AU - Lampertico, Pietro
AU - Donato, Maria Francesca
AU - De Nicola, Stella
AU - Prati, Gian Maria
AU - De Franchis, Roberto
AU - Colombo, Massimo
PY - 2011
Y1 - 2011
N2 - 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.
AB - 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.
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U2 - 10.3851/IMP1807
DO - 10.3851/IMP1807
M3 - Article
C2 - 21817189
AN - SCOPUS:80052441244
VL - 16
SP - 677
EP - 684
JO - Antiviral Therapy
JF - Antiviral Therapy
SN - 1359-6535
IS - 5
ER -