Long-term Effect of the HCV Elimination With Direct-acting Antivirals on the Progression of Gastroesophageal Varices.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2024-11-01 DOI:10.21873/invivo.13779

Yukihisa Yuri, Takashi Nishimura, Naoto Ikeda, Tomoyuki Takashima, Nobuhiro Aizawa, Taro Kimura, Kohei Yoshihara, Ryota Yoshioka, Shoki Kawata, Yuta Kawase, Ryota Nakano, Hideyuki Shiomi, Shinya Fukunishi, Shinichiro Shinzaki, Hirayuki Enomoto

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引用次数: 0

Abstract

Background/aim: Gastroesophageal varices (GEV) hemorrhage is a serious complication that can lead to unfavorable outcomes in cirrhotic patients. However, the clinical impact of HCV elimination [sustained viral response (SVR)] by direct-acting antivirals (DAAs), particularly on the long-term effects on the endoscopic findings of GEV have not been sufficiently evaluated. This study aimed to investigate whether HCV elimination with DAA treatment suppresses the progression of GEV.

Patients and methods: The clinical courses of the endoscopic findings of GEV were retrospectively compared between patients without an SVR (non-SVR group: n=71) and those who achieved an SVR with DAAs (DAA-SVR group: n=38).

Results: At 1, 3, 5, and 7 years, the cumulative GEV progression rates were 8.7%, 32.8%, 45.6%, and 66.2%, respectively. At 3 years, the cumulative GEV progression rate in the DAA-SVR group was similar to that in the non-SVR group. Beyond 3 years, cases with GEV progression were found in the non-SVR group, but not in the DAA-SVR group. At 7 years, the cumulative GEV progression rate in the DAA-SVR group was significantly lower than that in the non-SVR group (p<0.05, log-rank test). Variceal hemorrhage occurred in eight patients in the non-SVR group, while no bleeding events were observed in the DAA-SVR group during the observational period [8/71 (11.3%) vs. 0/38 (0.0%), p<0.05].

Conclusion: DAA treatment suppresses the progression of GEV over the long term.

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直接作用抗病毒药物消除丙肝病毒对胃食管静脉曲张进展的长期影响

背景/目的：胃食管静脉曲张（GEV）出血是一种严重的并发症，可导致肝硬化患者的不良预后。然而，尚未充分评估直接作用抗病毒药物（DAAs）消除 HCV（持续病毒应答（SVR））的临床影响，尤其是对 GEV 内镜检查结果的长期影响。本研究旨在探讨通过 DAA 治疗消除 HCV 是否会抑制 GEV 的进展：回顾性比较了未获得 SVR 的患者（非 SVR 组：71 人）和使用 DAA 获得 SVR 的患者（DAA-SVR 组：38 人）的 GEV 内镜检查结果的临床过程：1年、3年、5年和7年时，累积GEV进展率分别为8.7%、32.8%、45.6%和66.2%。3年后，DAA-SVR组的累积GEV进展率与非SVR组相似。3 年后，非 SVR 组出现了 GEV 进展病例，但 DAA-SVR 组没有。7年后，DAA-SVR组的累积GEV进展率明显低于非SVR组（p结论：DAA治疗可长期抑制GEV的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.