The long-term prospective study of patients with liver cirrhosis after elimination of the hepatitis C virus
- Authors: Nabatchikova E.A.1, Abdurakhmanov D.T.1, Nikulkina E.N.1, Rozina T.P.1,2, Tanaschuk E.L.1, Nikiforova N.V.1, Adonyeva V.S.3, Moiseev S.V.1,2
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Affiliations:
- Sechenov First Moscow State Medical University (Sechenov University)
- Lomonosov Moscow State University
- Botkin City Hospital
- Issue: Vol 92, No 2 (2020)
- Pages: 34-42
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/33898
- DOI: https://doi.org/10.26442/00403660.2020.02.000511
- ID: 33898
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Abstract
Aim. To study liver function and portal hypertension, incidence and risk factors of liver-related complications, including hepatocellular carcinoma (HCC), in patients with HCV-related liver cirrhosis achieved sustained virologic response (SVR) after direct-acting antiviral therapy.
Materials and methods. Patients with HCV-related liver cirrhosis were followed up after achievement SVR with assessment of liver function parameters, portal hypertension, Model for End-stage Liver Disease (MELD) and Сhild – Pugh (CP) scores, complications development, including HCC, every 3–6 months. The median follow-up duration was 24 [18; 30] months after end of treatment.
Results. At last observation, a number of cirrhotic patients with CP class A increased from 72% to 85%, with CP class B reduced from 23.5% to 12.5%, with CP class C – from 4.5% to 2.5%. In 89% patients were identified a regress of liver fibrosis (from 23.5 [16.9; 28] to 15.0 [10.2; 21.3] kPa, p<0.005), each third patient – reduction of fibrosis stage to F2/F3. In 19 (9.5%) patients were occurred liver-related complications, including HCC (in 9 patients). Baseline high total bilirubin level (≥34 µmol/l) (Hazard ratio (HR) 11.5, 95% confidence interval (CI) 2.3–57.8, р<0.005) and ascites (HR=17.6, 95% CI 2.1–144.8, p=0.008) were independent risk factors associated with HCC development.
Conclusion. The risk of HCC development remains in patients with HCV-related liver cirrhosis, despite on eradication of hepatitis C virus. Therefore, these patients should continue to undergo more intensive examination (ultrasound examination and determination of alfa-fetoprotein level each 3–6 months), including contrast-enhanced methods of imaging, the frequency of which should be determined.
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##article.viewOnOriginalSite##About the authors
E. A. Nabatchikova
Sechenov First Moscow State Medical University (Sechenov University)
Author for correspondence.
Email: e.nabat4ikova@gmail.com
ORCID iD: 0000-0003-4534-7991
аспирант каф. внутренних, профессиональных болезней и ревматологии
Russian Federation, MoscowD. T. Abdurakhmanov
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.nabat4ikova@gmail.com
д.м.н., проф. каф. внутренних, профессиональных болезней и ревматологии
Russian Federation, MoscowE. N. Nikulkina
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.nabat4ikova@gmail.com
ассистент каф. внутренних, профессиональных болезней и ревматологии
Russian Federation, MoscowT. P. Rozina
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Email: e.nabat4ikova@gmail.com
к.м.н., доц. каф. внутренних, профессиональных болезней и ревматологии; доц. каф. внутренних болезней факультета фундаментальной медицины.
Russian Federation, MoscowE. L. Tanaschuk
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.nabat4ikova@gmail.com
к.м.н., ассистент каф. внутренних, профессиональных болезней и ревматологии
Russian Federation, MoscowN. V. Nikiforova
Sechenov First Moscow State Medical University (Sechenov University)
Email: e.nabat4ikova@gmail.com
зав. отд-нием гепатологии Клиники ревматологии, нефрологии и профессиональных болезней им. Е.М. Тареева
Russian Federation, MoscowV. S. Adonyeva
Botkin City Hospital
Email: e.nabat4ikova@gmail.com
зав. областным гепатологическим центром БУЗ Орловской области
Russian Federation, OrelS. V. Moiseev
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Email: e.nabat4ikova@gmail.com
д.м.н., проф., зав. каф. внутренних, профессиональных болезней и ревматологии; проф. каф. внутренних болезней факультета фундаментальной медицины
Russian Federation, MoscowReferences
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