Risk factors for the exacerbation of esophageal varices or portosystemic encephalopathy after sustained virological response with IFN therapy for HCV-related compensated cirrhosis
详细信息 查看全文
- 作者：Yuko Nagaoki (1)
Hiroshi Aikata (1)
Tomoki Kobayashi (1)
Takayuki Fukuhara (1)
Keiichi Masaki (1)
Mio Tanaka (1)
Noriaki Naeshiro (1)
Takashi Nakahara (1)
Yohji Honda (1)
Daisuke Miyaki (1)
Tomokazu Kawaoka (1)
Shintaro Takaki (1)
Masataka Tsuge (1)
Akira Hiramatsu (1)
Michio Imamura (1)
Hideyuki Hyogo (1)
Yoshiiku Kawakami (1)
Shoichi Takahashi (1)
Hidenori Ochi (1)
Kazuaki Chayama (1) - 关键词：HCV ; related cirrhosis ; Interferon therapy ; Sustained virological response ; Esophageal varices ; Portosystemic encephalopathy ; Portosystemic collateral vessels
- 刊名：Journal of Gastroenterology
- 出版年：2013
- 出版时间：July 2013
- 年：2013
- 卷：48
- 期：7
- 页码：847-855
- 全文大小：505KB
- 参考文献：1. Sangiovanni A, Prati GM, Fasani P, Ronchi G, Romeo R, Manini M, et al. The natural history of compensated cirrhosis due to hepatitis C virus: a 17-year cohort study of 214 patients. Hepatology. 2006;43:1303-0. CrossRef
2. Bruno S, Zuin M, Crosignani A, Rossi S, Zadra F, Roffi L, et al. Predicting mortality risk in patients with compensated HCV-induced cirrhosis: a long-term prospective study. Am J Gastroenterol. 2009;104:1147-8. CrossRef
3. Benvegnú L, Gios M, Boccato S, Alberti A. Natural history of compensated viral cirrhosis: a prospective study on the incidence and hierarchy of major complications. Gut. 2004;53:744-.
4. Kasahara A, Hayashi N, Mochizuki K, Takayanagi M, Yoshioka K, Kakumu S, et al. Risk factors for hepatocellular carcinoma and its incidence after interferon treatment in patients with chronic hepatitis C. Osaka Liver Disease Study Group. Hepatology. 1998;27:1394-02. CrossRef
5. Ikeda K, Saitoh S, Arase Y, Chayama K, Suzuki Y, Kobayashi M, et al. Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: a long-term observation study of 1643 patients using statistical bias correction with proportional hazard analysis. Hepatology. 1999;29:1124-0. CrossRef
6. Yoshida H, Tateishi R, Arakawa Y, Sata M, Fujiyama S, Nishiguchi S, et al. Benefit of interferon therapy in hepatocellular carcinoma prevention for individual patients with chronic hepatitis C. Gut. 2004;53:425-0. CrossRef
7. Nishiguchi S, Kuroki T, Nakatani S, Morimoto H, Takeda T, Nakajima S, et al. Randomised trial of effects of interferon-alpha on incidence of hepatocellular carcinoma in chronic active hepatitis C with cirrhosis. Lancet. 1995;346:1051-. CrossRef
8. International Interferon-alpha Hepatocellular Carcinoma Study Group. Effect of interferon alpha on progression of cirrhosis to hepatocellular carcinoma: a retrospective cohort study. Lancet. 1998;351:1535-. CrossRef
9. Hu KQ, Tong MJ. The long-term outcomes of patients with compensated hepatitis C virus-related cirrhosis and history of parenteral exposure in the United States. Hepatology. 1999;29:1311-. CrossRef
10. Jeong S, Aikata H, Katamura Y, Azakami T, Kawaoka T, Saneto H, et al. Low-dose intermittent interferon-alpha therapy for HCV-related liver cirrhosis after curative treatment of hepatocellular carcinoma. World J Gastroenterol. 2007;13:5188-5.
11. Ikeda K, Saitoh S, Koboyashi M, Suzuki Y, Suzuki A, Tsubota A, et al. Long-term interferon therapy for 1?year or longer reduces the hepatocellular carcinogenesis rate in patients with liver cirrhosis caused by hepatitis C virus: a pilot study. J Gastroenterol Hepatol. 2001;16:406-5. CrossRef
12. Sarin SK, Lamba GS, Kumar M, Misra A, Murthy NS. Comparison of endoscopic ligation and propranolol for the primary prevention of variceal bleeding. N Engl J Med. 1999;340:988-3. CrossRef
13. Moriwaki H, Miwa Y, Tajika M, Kato M, Fukushima H, Shiraki M. Branched-chain amino acids as a protein and energy source in liver cirrhosis. Biochem Biophys Res Commun. 2004;313:405-. CrossRef
14. Gundling F, Teich N, Strebel HM, Schepp W, Pehl C. Nutrition in liver cirrhosis. Med Klin. 2007;102:435-4. CrossRef
15. D’Amico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology. 1995;22:332-4.
16. Lay CS, Tsai YT, Teg CY, Shyu WS, Guo WS, et al. Endoscopic variceal ligation in prophylaxis of first variceal bleeding in cirrhosis patients with high-risk esophageal varices. Hepatology. 1997;25:1346-0. CrossRef
17. Garcia-Tsao G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology. 2001;120:726-8. CrossRef
18. Pagliaro L, D’Amico G, Sorensen TI, Lebrec D, Burroughs AK, Morabito A, et al. Prevention of first bleeding in cirrhosis: a meta-analysis of randomized trials of nonsurgical treatment. Ann Intern Med. 1992;117:59-0. CrossRef
19. The Japan Society for Portal Hypertension and Esophageal Varices. The general rules for study of portal hypertension. 2nd ed. Tokyo: Kanehara; 2004. p. 37- (in Japanese).
20. Cammà C, Giunta M, Andreone P, Craxi A. Interferon and prevention of hepatocellular carcinoma in viral cirrhosis: an evidence-based approach. J Hepatol. 2001;34:593-02. CrossRef
21. Heathcote EJ, Shiffman ML, Cooksley WG, Samuel S, Lee SS, Balart L, et al. Peginterferon alfa-2a in patients with chronic hepatitis C and cirrhosis. N Engl J Med. 2000;343:1673-0. CrossRef
22. Cammà C, Di Bona D, Schepis F, Heathcote J, Stefan Zeuzem S, Pockros PJ, et al. Effect of peginterferon alfa-2a on liver histology in chronic hepatitis C: a meta-analysis of individual patient data. Hepatology. 2004;39:333-2. CrossRef
23. Tanabe J, Izawa A, Takemi N, Miyauchi Y, Torii Y, Tsuchiyama H, et al. Interferon-beta reduces the mouse liver fibrosis induced by repeated administration of concanavalin A via the direct and indirect effects. Immunology. 2007;122:562-0. CrossRef
24. Inagaki Y, Nemoto T, Kushida M, Sheng Y, Higashi K, Ikeda K, et al. Interferon alfa down-regulates collagen gene transcription and suppresses experimental hepatic fibrosis in mice. Hepatology. 2003;38:890-.
25. Rincon D, Ripoll C, Lo Iacono O, Salcedo M, Catelina MV, Alvarez E, et al. Antiviral therapy decreases hepatic venous pressure gradient in patients with chronic hepatitis C and advanced fibrosis. Am J Gastroenterol. 2006;101:2269-4. CrossRef
26. Roberts S, Gordon A, McLean C, Pedersen J, Bowden S, Thomson K, Augus P. Effect of sustained viral response on hepatic venous pressure gradient in hepatitis C-related cirrhosis. Clin Gastroenterol Hepatol. 2007;5:932-. CrossRef
27. Di Bisceglie AM, Shiffman ML, Everson GT, Lindsay KL, Everthart JE, Wright EC, et al. Prolonged therapy of advanced chronic hepatitis C with low-dose peginterferon. N Engl J Med. 2008;359:2429-1. CrossRef
28. Kodama H, Aikata H, Takaki S, Azakami T, Katamura Y, Kawaoka T, et al. Evaluation of portosystemic collaterals by MDCT-MPR imaging for management of hemorrhagic esophageal varices. Eur J Radiol. 2010;76:239-5. CrossRef
29. Kodama H, Aikata H, Takaki S, Takahashi S, Toyota N, Ito K, et al. Evaluation of patients with esophageal varices after endoscopic injection sclerotherapy using multiplanar reconstruction MDCT images. AJR Am J Roentgenol. 2009;192:122-0. CrossRef
30. Kobayashi M, Ikeda K, Hosaka T, Sezaki H, Someya T, Akuta N, et al. Natural history of compensated cirrhosis in the Child–Pugh class A compared between 490 patients with hepatitis C and 167 with B virus infections. J Med Virol. 2006;78:459-5. CrossRef
31. Bruno S, Stroffolini T, Colombo M, Bollani S, Benvegnú L, Mazzella G, et al. Sustained virological response to interferon-α is associated with improved outcome in HCV-related cirrhosis: a retrospective study. Hepatology. 2007;45:579-7. CrossRef
32. Morgan TR, Ghany MG, Kim HY, Snow KK, Shiffman ML, De Santo JL, Lee WM, et al. Outcome of sustained virological responders with histologically advanced chronic hepatitis C. Hepatology. 2010;52:833-4. CrossRef - 作者单位：Yuko Nagaoki (1)
Hiroshi Aikata (1)
Tomoki Kobayashi (1)
Takayuki Fukuhara (1)
Keiichi Masaki (1)
Mio Tanaka (1)
Noriaki Naeshiro (1)
Takashi Nakahara (1)
Yohji Honda (1)
Daisuke Miyaki (1)
Tomokazu Kawaoka (1)
Shintaro Takaki (1)
Masataka Tsuge (1)
Akira Hiramatsu (1)
Michio Imamura (1)
Hideyuki Hyogo (1)
Yoshiiku Kawakami (1)
Shoichi Takahashi (1)
Hidenori Ochi (1)
Kazuaki Chayama (1)
1. Programs for Applied Biomedicine, Division of Frontier Medical Science, Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
文摘
Background We aimed to identify risk factors contributing to the exacerbation of esophageal varices (EV) or portosystemic encephalopathy after hepatitis C virus (HCV) eradication with interferon (IFN) therapy in patients with compensated cirrhosis. Also, the prognosis after HCV eradication was analyzed. Methods Fifty-two patients with sustained virological response to IFN treatment for HCV-related compensated cirrhosis were enrolled in this retrospective cohort study. Results At the achievement of HCV eradication, in 31 of the 52 patients (60?%), feeding vessels for EVs (left gastric vein, posterior gastric vein, short gastric vein) were shown, and in 18 patients (35?%) there were extrahepatic portosystemic shunts (paraesophageal vein, paraumbilical vein, and splenorenal shunt). Although the HCV eradication was successful, significant improvements were not observed in portosystemic collateral vessels 1?year after HCV eradication, and EVs were exacerbated in 19 (36?%) patients. The cumulative 1- and 3-year rates of EV exacerbation were 13?% and 49?%, respectively. By multivariate analysis, the existence of feeding vessels for EVs at HCV eradication was an independent predictive factor for the exacerbation of EVs (P?=?0.009). Seven patients who had an extrahepatic portosystemic shunt at HCV eradication developed portosystemic encephalopathy during follow up. The 1-, 3-, and 5-year incidences of portosystemic encephalopathy were 6, 21, and 34?%, respectively. The cumulative 5-year survival rate of the cohort was 81?%. Two patients died of hepatocellular carcinoma (HCC). Conclusions Our findings suggest that the existence of radical portosystemic collateral vessels at successful HCV eradication increases the risk of the exacerbation of EVs and the incidence of portosystemic encephalopathy in patients with HCV-related cirrhosis.