Abstract
Background and AimsTo prospectively evaluate the effects of antiviral therapy on liver hemodynamics in patients with hepatitis B cirrhosis.MethodsSeventy consecutive eligible HBV-related cirrhotic inpatients were enrolled in the prospective study. Fifty-two received different nucleoside analogs monotherapy and 18 denied antiviral therapy. Their liver biochemistry profiles and HBV-DNA were measured at the baseline and every 3 months. Peripheral blood vWF and sCD163, as well as liver ultrasound Doppler parameters including portal vein diameter (PVD), portal vein velocity (PVV), portal vein congestion index (PV-CI), hepatic vein damping index (HV-DI), hepatic arterial arrival time (HAAT), hepatic vein arrival time (HVAT) and intrahepatic cycle time (HV-HA), were measured at the baseline and the follow-up periods.ResultsIn the antiviral group, all patients achieved complete virologic and liver biochemical responses after 3-month antiviral treatment. Furthermore, the response states were maintained till the follow-up endpoint. However, in the non-antiviral group, HBV DNA replication resulted in higher levels of ALT and AST compared to the baseline values (P < 0.05). In the antiviral group, PVD, PV-CI, HV-DI, vWF-Ag and sCD163 were all significantly reduced than the baseline values (P < 0.05), and PVV was significantly increased than the baseline value (P < 0.05).ConclusionsAntiviral therapy could effectively suppress hepatocyte inflammation and alleviate the dysfunction of intrahepatic vascular endothelial and hepatic macrophages, which might improve hepatic hemodynamic function in HBV-related cirrhosis.
Highlights
Hepatitis B virus (HBV)-associated cirrhosis with portal hypertension is a life-threatening condition
We demonstrated that long-term antiviral therapy could improve hepatic hemodynamic dysfunction by decreasing hepatic macrophages activation and alleviating intrahepatic vascular endothelial dysfunction in cirrhotic patients with active HBV replication and liver inflammation
Inclusion criteria for this study included: 1, diagnosis of liver cirrhosis based on clinical, histology, ultrasonography, computed tomography (CT) or magnetic resonance imaging (MRI); 2, positive HBsAg for ≥12 months; 3, age between18 to 75 years old; 4, elevated serum aspartate (AST) and/or alanine aminotransaminase (ALT) levels on ≥ 2 times during the previous 12 months; 5, serum HBV DNA (>1,000 copies/mL) detectable by polymerase chain reaction (PCR) (Fluorescence Quantitation kit; Shanghai ZJ Bio-Tech Co., Ltd., Shanghai, China)
Summary
Hepatitis B virus (HBV)-associated cirrhosis with portal hypertension is a life-threatening condition. How to cite this article Xu et al (2018), Antiviral therapy effectively improves liver hemodynamics as evidenced by serum biomarker and contrast-enhanced ultrasound examinations in patients with hepatitis B cirrhosis. There have been extensive studies toward finding effective and noninvasive approaches to evaluate portal hypertension by focusing on a panel of biochemical markers and Doppler ultrasound methods. To prospectively evaluate the effects of antiviral therapy on liver hemodynamics in patients with hepatitis B cirrhosis. Fifty-two received different nucleoside analogs monotherapy and 18 denied antiviral therapy Their liver biochemistry profiles and HBV-DNA were measured at the baseline and every 3 months. Antiviral therapy could effectively suppress hepatocyte inflammation and alleviate the dysfunction of intrahepatic vascular endothelial and hepatic macrophages, which might improve hepatic hemodynamic function in HBV-related cirrhosis
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