Impact of Sustained Viral Response in the Evolution of Minimal Hepatic Encephalopathy: a Prospective Pilot Study

Annals of Hepatology

Carlos Fernández-Carrillo¹  Marta Hernández-Conde²  José L. Calleja³  Natalia Fernández-Puga³  Christie Perelló³  Marta López-Gómez³  Elba Llop³  José L. Martínez-Porras³ 

[1] Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain;Correspondence and reprint request:;Department of Gastroenterology and Hepatology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain;

关键词: HCV;    MHE;    Direct-acting antivirals;    Critical flicker frequency;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction and aims: To determine the prevalence of minimal hepatic encephalopathy (MHE) in patients with liver cirrhosis (LC) due to hepatitis C virus (HCV) infection and to evaluate the impact of sustained viral response (SVR) on MHE. Material and methods: We performed a prospective study using MHE screening and follow-up on patients with HCV and LC. The patients were evaluated at the beginning of treatment and 24 weeks after treatment. Results: 64 patients were included. 51.6% were male, the median age was 62years, Child-Pugh classification A/B/C 93.8%/4.7%/1.6% and median MELD was 8.3. Prior hydropic decompensation was present in 11 patients. Median values of liver stiffness, as measured by transient elastography (TE) were 22.8 KPa. Indirect signs of portal hypertension (PH) were present in 53.1% of patients, with a mean of 11.9 mmHg among the ones with a measurement of the hepatic venous pressure gradient. The prevalence of MHE before treatment was 26.6%. After treatment, 98.4% of patients achieved SVR. The presence of MHE at 24weeks post-treatment had an statistically significant association with the presence of pre-treatment MHE (80% vs. 21.6%; p < 0.01), higher MELD scores at 24-weeks post-treatment (9.8 vs. 8; p = 0.02), higher Child-Pugh scores at 24-weeks post-treatment (p = 0.04), higher baseline INR levels (1.4 vs. 1.1; p < 0.001) and with the presence of indirect signs of PH (100% vs. 47.1%; p = 0.02). During follow-up, those patients without MHE at 24weeks post-treatment had a higher probability of experiencing an improvement in post-treatment TE (80.9% vs. 40%, p = 0.04). Conclusion: We found that SVR may lead to MHE resolution in a considerable proportion of patients, which has potential implications for disease prognosis.

【 授权许可】

Unknown