Factors involved in gastroesophageal varix-related events in patients with hepatitis C virus-related compensated and decompensated cirrhosis after direct-acting antiviral therapy

被引：3

作者：

Tahata, Yuki ^{[1
]}

Hikita, Hayato ^{[1
]}

Mochida, Satoshi ^{[2
]}

Enomoto, Nobuyuki ^{[3
]}

Kawada, Norifumi ^{[4
]}

Ido, Akio ^{[5
]}

Miki, Daiki ^{[6
]}

Kurosaki, Masayuki ^{[7
]}

Yoshiji, Hitoshi ^{[8
]}

Sakamori, Ryotaro ^{[1
]}

Kuroda, Hidekatsu ^{[9
]}

Yatsuhashi, Hiroshi ^{[10
]}

Yamashita, Taro ^{[11
]}

Hiasa, Yoichi ^{[12
]}

Kato, Naoya ^{[13
]}

Miyaaki, Hisamitsu ^{[14
]}

Ueno, Yoshiyuki ^{[15
]}

Itoh, Yoshito ^{[16
]}

Matsuura, Kentaro ^{[17
]}

Takami, Taro ^{[18
]}

Asahina, Yasuhiro ^{[19
]}

Suda, Goki ^{[20
]}

Akuta, Norio ^{[21
]}

Tateishi, Ryosuke ^{[22
]}

Nakamoto, Yasunari ^{[23
]}

Kakazu, Eiji ^{[24
]}

Terai, Shuji ^{[25
]}

Shimizu, Masahito ^{[26
]}

Miyazaki, Masanori ^{[27
]}

Nozaki, Yasutoshi ^{[28
]}

Sobue, Satoshi ^{[29
]}

Yano, Hiroki ^{[30
]}

Miyaki, Tomokatsu ^{[31
]}

Moriuchi, Akihiro ^{[32
]}

Hori, Takeshi ^{[33
]}

Shirai, Kumiko ^{[1
]}

Murai, Kazuhiro ^{[1
]}

Saito, Yoshinobu ^{[1
]}

Kodama, Takahiro ^{[1
]}

Tatsumi, Tomohide ^{[1
]}

Yamada, Tomomi ^{[34
]}

Takehara, Tetsuo ^{[1
]}

机构：

[1] Osaka Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan

[2] Saitama Med Univ, Dept Gastroenterol & Hepatol, Saitama, Japan

[3] Univ Yamanashi, Fac Med, Dept Internal Med 1, Yamanashi, Japan

[4] Osaka Metropolitan Univ, Grad Sch Med, Dept Hepatol, Osaka, Japan

[5] Kagoshima Univ, Grad Sch Med & Dent Sci, Dept Human & Environm Sci, Digest & Lifestyle Dis, Kagoshima, Japan

[6] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Gastroenterol & Metab, Hiroshima, Japan

[7] Musashino Red Cross Hosp, Dept Gastroenterol & Hepatol, Tokyo, Japan

[8] Nara Med Univ, Dept Gastroenterol, Nara, Japan

[9] Iwate Med Univ, Dept Internal Med, Div Hepatol, Yahaba, Iwate, Japan

[10] Natl Hosp Org, Nagasaki Med Ctr, Clin Res Ctr, Nagasaki, Japan

[11] Kanazawa Univ, Grad Sch Med, Dept Gastroenterol, Kanazawa, Ishikawa, Japan

[12] Ehime Univ, Grad Sch Med, Dept Gastroenterol & Metabol, Toon, Ehime, Japan

[13] Chiba Univ, Grad Sch Med, Dept Gastroenterol, Chiba, Japan

[14] Nagasaki Univ, Grad Sch Biomed Sci, Dept Gastroenterol & Hepatol, Nagasaki, Japan

[15] Yamagata Univ, Fac Med, Dept Gastroenterol, Yamagata, Japan

[16] Kyoto Prefectural Univ Med, Grad Sch Med Sci, Dept Mol Gastroenterol & Hepatol, Kyoto, Japan

[17] Nagoya City Univ, Grad Sch Med Sci, Dept Gastroenterol & Metab, Nagoya, Japan

[18] Yamaguchi Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Ube, Yamaguchi, Japan

[19] Tokyo Med & Dent Univ, Dept Liver Dis Control, Dept Gastroenterol & Hepatol, Tokyo, Japan

[20] Hokkaido Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Sapporo, Hokkaido, Japan

[21] Toranomon Gen Hosp, Dept Hepatol, Tokyo, Japan

[22] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[23] Univ Fukui, Fac Med Sci, Dept Internal Med 2, Fukui, Japan

[24] Natl Ctr Global Hlth & Med, Res Ctr Hepatitis & Immunol, Chiba, Japan

[25] Niigata Univ, Grad Sch Med & Dent Sci, Div Gastroenterol & Hepatol, Niigata, Japan

[26] Gifu Univ, Grad Sch Med, Dept Gastroenterol Internal Med, Gifu, Japan

[27] Osaka Police Hosp, Dept Gastroenterol, Osaka, Japan

[28] Kansai Rosai Hosp, Dept Pathol, Amagasaki, Hyogo, Japan

[29] Kasugai Municipal Hosp, Dept Gastroenterol, Kasugai, Aichi, Japan

[30] Oshima Hosp, Dept Gastroenterol, Kagoshima, Japan

[31] Toyokawa City Hosp, Dept Gastroenterol, Toyokawa, Japan

[32] Natl Hosp Org, Dept Gastroenterol, Kagoshima Med Ctr, Kagoshima, Japan

[33] Kagoshima City Hosp, Dept Gastroenterol, Kagoshima, Japan

[34] Osaka Univ Hosp, Dept Med Innovat, Suita, Osaka, Japan

来源：

HEPATOLOGY RESEARCH | 2025年 / 55卷 / 03期

关键词：

DAA; esophagogastric varix; HCV; sustained virologic response; varix aggravation; varix rupture; CLINICAL-PRACTICE GUIDELINES; GENOTYPE; NATURAL-HISTORY; SOFOSBUVIR; LEDIPASVIR;

D O I：

10.1111/hepr.14131

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

AimThe incidence of and factors involved in gastroesophageal varix-related events in hepatitis C virus-related cirrhosis patients, including decompensated cirrhosis, after direct-acting antiviral therapy are unclear. MethodsWe conducted a multicenter study using prospective data from 478 hepatitis C virus-related cirrhosis patients treated with direct-acting antiviral therapy from February 2019 to December 2021 at 33 Japanese hospitals. Gastroesophageal varices were classified as F1 (small-caliber), F2 (moderately enlarged), or F3 (markedly enlarged) according to the Japanese criteria. Patients without varix or with F1 without red color signs were defined as low-risk varix, and patients with >= F2 or red color signs or a history of rupture were defined as high-risk varix. Varix-related events were defined as prophylactic treatment or rupture of gastroesophageal varix. ResultsThe median age was 70 years, 43% of patients had decompensated cirrhosis, and 16% had high-risk varices (13% in compensated and 33% in decompensated, p < 0.001). Sustained virologic response rates were 94.9% for compensated cirrhosis and 91.3% for decompensated cirrhosis (p = 0.120). Across 35.7 months, 25 patients received prophylactic treatment, and four experienced varix rupture. The 3-year incidence rate of varix-related events was 6.2% (3.5% in compensated and 9.9% in decompensated, p = 0.001). In the multivariate analysis, high-risk varix (p < 0.001), high baseline gamma-glutamyl transpeptidase levels (p < 0.001), and virologic failure (p = 0.004) were significantly involved in varix-related events. ConclusionsThe cumulative incidence rate of varix-related events was significantly higher in decompensated cirrhosis than in compensated cirrhosis. Baseline varix status, baseline gamma-glutamyl transpeptidase levels, and virologic response were related to varix-related events after direct-acting antiviral therapy.

引用

页码：319 / 332

页数：14

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