Even after chronic hepatitis C has been cured, portal hypertension stays the foremost factor driving the event of complications in advanced liver disease. In cooperation with researchers from Spain, a research team led by Georg Semmler and Mattias Mandorfer from the Division of Gastroenterology and Hepatology at MedUni Vienna’s Department of Medicine III showed that the non-invasive tests explored of their earlier studies accurately estimate the probability of sequelae. Their study, published in the celebrated Journal of Hepatology, refutes concerns in regards to the accuracy of those tests and recommends actions for individual disease follow-up.

Of their latest study, the research group analysed all published data regarding non-invasive tests and minimally invasive hepatic venous pressure gradient measurements performed on patients before and after treatment for hepatitis C. Working closely with colleagues from Spain, they evaluated paired measurements from 418 patients, confirming the accuracy of two non-invasive tests: US-based liver stiffness measurement and platelet count, a straightforward blood test. Based on these findings, it was possible to develop a risk stratification system for patients post hepatitis C cure and this has already been implemented within the Baveno VII consensus, i.e. the international recommendations for the management of portal hypertension.

The outcomes of the study are subsequently already contributing to the personalised follow-up of those patients worldwide, eliminating the necessity for unnecessary, sometimes burdensome examinations and enabling early initiation of preventive measures where appropriate.”

Georg Semmler, Study First Writer, Medical University of Vienna

Hepatitis C is a viral infection that’s widespread throughout the world. For some years now, it has been successfully treated with drugs which have a direct antiviral effect and might thus be cured in over 95% of cases. Nonetheless, patients with advanced scarring of the liver (“advanced liver disease”) remain prone to developing secondary disease. Except hepatocellular carcinoma, these complications are directly attributable to the presence of portal hypertension. This refers to hypertension in the massive vein that transports blood from the gut to the liver. As a way to provide follow-up care after hepatitis C, it is crucial that portal hypertension may be accurately identified via non-invasive testing. “Our study has made it possible to accurately predict individual risk after hepatitis C has been cured. While it is feasible to stop surveillance in a high proportion of patients, it’s urgently beneficial that preventive drug treatment is initiated or continued in others,” adds study leader Matthias Mandorfer.

Source:

Medical University of Vienna

Journal reference:

Semmler, G., et al. (2022) Non-invasive tests for clinically significant portal hypertension after HCV cure. Journal of Hepatology. doi.org/ 10.1016/j.jhep.2022.08.025.