![](images/null.gif) |
![](images/null.gif) |
![](images/null.gif) |
|
Portal Pressure Changes After HCV Eradication in HIV/HCV+ Patients With Cirrhosis
|
|
|
Reported by Jules Levin
CROI 2015 Feb 23-26, Seattle, WA
Sanchez-Conde M1, Perez-Latorre L1,2, Rincon D1,2, Miralles P1,2, Catalina MV1,2, Lopez JC1,2, Banares R1,2,3, Berenguer J1,2
1Hospital General Universitario Gregorio Maranon, 2Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), 3Universidad Complutense, Madrid, SPAIN
![CROI1.gif](../images/032015/032015-5/CROI1.gif)
![CROI2.gif](../images/032015/032015-5/CROI2.gif)
![CROI3.gif](../images/032015/032015-5/CROI3.gif)
program abstract
Background: In patients with compensated cirrhosis (CR), hepatic venous pressure gradient (HVPG) is the most accurate predictor of liver-related events (LRE). In cirrhotic patients receiving pharmacologic treatment for prevention of variceal rebleeding, a decrease in HVPG ≥ 20% or to ≤ 12 mm Hg is associated with a marked reduction in the long-term risk of developing LRE and with improved survival (Hepatology 2003;37:902-908). We assessed the effect of sustained viral response (SVR) after pegylated interferon plus ribavirin (PR) on HVPG in HIV/HCV+ patients with CR.
Methods: We reviewed the records of the portal hemodynamic laboratory of our institution to identify all HIV/HCV+ patients with CR who had a determination of HVPG before and after PR therapy between 2007 and 2012.
Results: HVPG was determined in 60 HIV/HCV+ patients with CR. A total of 27/60 patients were treated with PR, and 15/27 treated patients achieved SVR. Consent to perform a 2nd HVPG determination was given by 8/15 patients with SVR. In these 8 patients, the 2nd HVPG determination was performed a median time of 18 (10 - 26) months after the discontinuation of PR. The median (IQR) HVPG was 15.5 (11.3-17.6) mmHg at baseline, and 8.8 (6.3-12.00) mmHg following SVR; P=0.01.
After SVR, 7/8 patients experienced a decrease in HVPG ≥ 20% and all 7 had HVPG ≤ 12 mm Hg. In one patient with SVR, HVPG decreased 10% with a last value of 13.3 mmHg. After a median follow-up time of 60 months, all 8 patients were alive and free from LRE. Figure 1 shows median and IQR values and individual values of HVPG at baseline and after SVR.
Conclusions: Our results suggest that eradication of HCV is associated with a marked and clinically significant reduction of HVPG in most HIV/HCV+ patients with CR and PH. However, some patients with CR and portal hypertension may remain at risk for LRE despite eradication of HCV.
![CROI4.gif](../images/032015/032015-5/CROI4.gif)
![CROI5.gif](../images/032015/032015-5/CROI5.gif)
![CROI6.gif](../images/032015/032015-5/CROI6.gif)
![CROI7.gif](../images/032015/032015-5/CROI7.gif)
![CROI8.gif](../images/032015/032015-5/CROI8.gif)
|
|
|
![](images/null.gif) |
![](images/null.gif) |
|
|