Abstract
Abstract Funding Acknowledgements Kantonsspital Olten, Switzerland Background In patients with chronic hepatitis C virus (HCV) infection, a higher risk for pulmonary artery hypertension (PAH) has been described after interferon (IFN) therapy. With the development of direct-acting antiviral (DAA) agents, vast improvements have been made in tolerance and less complications of HCV treatment. However, except of a few case reports, to date no clinical study about the evidence of PAH in patients with DAA medication for HCV infection has been published. We hypothesized that in patients, who receive DAA medication for HCV-infection, the systolic pulmonary artery pressure (sPAP) will not change significantly during and after competition of the therapy and there may be a lower post treatment risk for PAH within the population. Methods We prospectively enrolled patients who underwent treatment with DAA for chronic HCV infection. The patients received a transthoracic echocardiography (TTE) for the measurement of the pulmonary artery pressure before, during (8 weeks after starting the medication) and 8 weeks after completion of the HCV medication for evaluation of sPAP (figure 1). The whole treatment period took 8-12 weeks. Results Between June 2016 and October 2018, 33 patients completed the study protocol. In mean, the patient’s age was 50.1 ± 1.4 years and 30% of the population were female. Three patients (9 %) were HCV and human immunodeficiency virus (HIV) coinfected. The patients received different treatment regimens, according to hepatitis C genotype and co-medication. The left ventricular systolic and diastolic function were normal in all patients before treatment was started (left ventricular ejection fraction 60.7% [59.7 – 61.7%], E/A 1.18 [1.0 – 1.37]). The following table depicts the right ventricular parameter before the DAA therapy was started, 8 weeks after therapy start, and 8 weeks after therapy was completed. The analysis showed no significant difference between the sPAP in all three groups (25.9 ± 1.2 mmHg vs. 26.0 ± 1.3 mmHg vs.26.9 ± 1.1 mmHg, p-value 0.37, see figure). Conclusion DAA-therapy in chronic HCV infected patients is not associated with PAH in a follow-up of 2 months after the treatment was completed. Echocardiography Data Echocardiography data Before DAA medication was started 8 weeks after DAA-therapy 8 weeks after completion of DAA-therapy p-Value Right ventricular fractional area change (FAC), % 49.1 ± 1.4 51.7 ± 1.0 51.8 ± 1.1 0.09 Tricuspid Annular Plane Systolic Excursion (TAPSE), mm 25.2 ± 1.1 25.8 ± 0.7 24.3 ± 0.5 0.4 Right ventricular/right atrial gradient, mmHg 19.9 ± 1.0 20.5 ± 0.9 21.0 ± 0.8 0.24 Systolic pulmonary artery pressure (sPAP), mmHg 25.9 ± 1.2 26.0 ± 1.3 26.9 ± 1.1 0.37 Abstract P834 Figure. Multiple variable graph of sPAP
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