von Willebrand factor antigen (vWF-Ag): A non-invasive predictor of treatment response and serious adverse events in HCV patients with interferon triple therapy

详细信息    查看全文

• 作者：Karoline Rutter^a ; ^b ; Alexandra Etschmaier^a ; Monika Ferlitsch^a ; Andreas Maieron^c ; Stephanie Hametner^c ; Thomas Horvatits^a ; ^b ; Rafael Paternostro^a ; Petra Salzl^a ; Thomas Reiberger^a ; Markus Peck-Radosavljevic^a ; Peter Quehenberger^d ; Harald Hofer^a ; Michael Trauner^a ; Peter Ferenci^a ; Arnulf Ferlitsch^a ; ^{arnulf.ferlitsch@meduniwien.ac.at" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Antiviral therapy ; Chronic hepatitis C ; DAA ; von Willebrand factor
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：48
• 期：10
• 页码：1194-1199
• 全文大小：549 K

文摘

Treatment of chronic hepatitis C virus (HCV) infection was revolutionized within the last years. Interferon free antiviral regimens are not accessible without limitations. Combination of peginterferon/ribavirin with first generation direct acting antivirals is less effective and associated with serious adverse events.

Aim

We have shown that vWF-Ag is associated with portal hypertension and treatment response to PEG/RBV and we evaluated if vWF-Ag is a predictive marker for treatment response and safety in patients with triple therapy.

Methods

222 HCV-GT 1 patients and DAA based triple therapy were included in this retrospective, multicenter study.

Results

Median vWF-Ag levels were 167.0% [IQR: 124.0–210.0%]. Significantly higher levels were seen in patients without SVR; median 190% [IQR: 146.0–259.5%] versus SVR: 142.5% [IQR: 114.3–196.8%], p < 0.001. Furthermore levels of vWF-Ag were identified as independent predictor of non SVR; (OR: 1.009; 95%CI: 1.016–1.3, p = 0.005). In patients with cirrhosis elevated vWF-Ag levels were associated with increased incidence of SAEs (OR: 1.016; 95%CI: 1.004–1.028; p = 0.007). Best cut off for prediction of SAEs was vWF-Ag > 281.5% with a sensitivity of 78% and a specificity of 90%.

Conclusion

Baseline vWF-Ag levels predict outcome of DAA based treatment in HCV-1 patients and identify patients with a risk of SAEs. Therefore vWF-Ag may be an additional marker for selecting patients for interferon free therapeutic regimens.