Sustained Virologic Response Prevents the Development of Esophageal Varices in Compensated, Child-Pugh Class A Hepatitis C Virus-Induced Cirrhosis. A 12-Year Prospective Follow-up Study
Sustained Virologic Response Prevents the Development of Esophageal Varices in Compensated, Child-Pugh Class A Hepatitis C Virus-Induced Cirrhosis. A 12-Year Prospective Follow-up Study
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DOI：
10.1002/hep.23528
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发表时间：
2010-06-01
期刊：
影响因子：
13.5
通讯作者：
Maisonneuve, Patrick
中科院分区：
文献类型：
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作者：
Bruno, Savino;Crosignani, Andrea;Maisonneuve, Patrick
代偿性肝硬化患者食管静脉曲张（EV）从头发生的发生率很少有短期研究确定，而长期研究则从未确定过。本研究的目的是确定与 EV 发生相关的发病率和危险因素，并评估抗病毒治疗和持续病毒学应答 (SVR) 的实现是否可以预防 HCV 诱导的肝硬化患者从头发生 EV。我们研究了 1989 年至 1992 年间在意大利米兰三个转诊中心连续入组的 218 名代偿性无 EV、HCV 诱发的肝硬化患者。根据国际指南，内窥镜监测每 3 年进行一次。 SVR 定义为停止治疗 24 周后血清 HCV-RNA 检测不到。在中位随访 11.4 年期间，149/218 (68%) 患者接受了抗病毒治疗，34 例 (22.8%) 患者实现了 SVR。与 69 名未治疗受试者中的 22 名 (31.8%) 受试者相比，SVR 患者中没有一名出现 EV（P
The incidence of de novo development of esophageal varices (EV) in patients with compensated liver cirrhosis has been determined by few studies in the short term and never in the long term. The aims of the present study were to determine the incidence and the risk factors associated with the development of EV and to assess whether antiviral treatment and achievement of sustained virologic response (SVR) may prevent de novo EV development in patients with HCV-induced cirrhosis. We studied 218 patients with compensated EV-free, HCV-induced cirrhosis consecutively enrolled between 1989 and 1992 at three referral centers in Milan, Italy. Endoscopic surveillance was performed at 3-year intervals according to international guidelines. SVR was defined as undetectable serum HCV-RNA 24 weeks after treatment discontinuation. During a median follow-up of 11.4 years, 149/218 (68%) patients received antiviral treatment and 34 (22.8%) achieved SVR. None of the SVR patients developed EV compared with 22 (31.8%) of the 69 untreated subjects (P