NONTUMORAL PORTAL VEIN THROMBOSIS IN PATIENTS WITH HEPATITIS C VIRUS AND SUSTAINED VIROLOGICAL RESPONSE - A FURTHER CHALLENGING CONSEQUENCE OF LIVER CIRRHOSIS
Abstract
The sustained virologic response (SVR) achieved by most patients treated with direct acting antivirals (DAAs) involves multiple benefits such as regression of fibrosis and improvement in liver function. However, DAAs therapy doesn’t eliminate the risk of thrombotic events. The aim of our study was to assess the prevalence of nontumoral portal vein thrombosis (PVT) after SVR and identification of risk factors associated with this complication. Material and methods: We retrospective analyzed a cohort of patients with HCV-related liver cirrhosis treated with paritaprevir/ritonavir, ombitasvir and dasabuvir (PrOD) ± ribavirin and ledipasvir/sofosbuvir (LED/SOF) ± ribavirin for 12/24 weeks, in a gastroenterology center from Romania, between October 2015 and December 2018. All patients with presumption of PVT were evaluated by abdominal ultrasound and confirmed by CT scan. Results: The study included 730 patients treated with DAAs, of which 35 were diagnosed with non-malignant PVT after-SVR (15 men and 20 women, mean age 57.86 ± 7.068 years), corresponding to a prevalence of 4.8%. The mean time from SVR to complication was 290.00 ± 116.639 days. Most patients with non-tumoral PVT after-SVR received LED/SOF (71.4%), while the rest received PrOD (28.6%). Twenty-four patients (68.6%) diagnosed with acute PVT and 11 patients (31.4%) with chronic PVT. During the study, an improvement in liver function was observed, with an improvement in the Child-Pugh and MELD score at the time of SVR; the evolution changes slightly at the 48-week assessment, with a slight increase in the proportion of patients with Child B and MELD ≥ 15. Conclusions: Occurrence of nonmalignant PVT in patients with HCV-related liver cirrhosis treated with DAAs correspond to the natural evolution of the cirrhotic patient.
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