Significance of portal venous blood flow as a factor to determine liver function in patients with decompensated cirrhosis due to hepatitis C virus infection following achievement of sustained viral response by sofosbuvir plus velpatasvir.

Abstract

To determine the outcomes concerning portal venous blood flow and portosystemic shunts in patients with decompensated cirrhosis due to hepatitis C virus (HCV) infection who achieved sustained viral response (SVR) following antiviral therapy. Portal hypertension-related events and liver function were evaluated in 24 patients achieving SVR following sofosbuvir plus velpatasvir therapy. Serum albumin level (median; g/dL) increased from 2.9 at baseline to 3.5 at 12weeks after the end of treatment (EOT) (p=0.005), while liver volumes (cm3 ) decreased from 1260 to 1150 (p=0.0002). Portal hypertension-related events developed in 10 patients (41.7%), and the cumulative occurrence rates after the EOT were 29.2%, 33.3%, and 46.1% at 24, 48, and 96weeks, respectively. Multivariate logistic regression analysis revealed that the maximal diameter of the shunts (p=0.0235) was associated with the development of the events, with a cut-off value of 8.3mm (p=0.0105). Meanwhile, multiple linear regression analysis revealed that portal venous blood flow, liver volume, serum albumin, and bilirubin levels at baseline were associated with serum albumin levels at 12weeks after EOT (p=0.0019, p=0.0154, p=0.0010, and p=0.0350, respectively). In patients with decompensated cirrhosis due to HCV infection, the baseline portal venous blood flow and liver volume and function were predictive of liver function following SVR, while the maximal diameter of portosystemic shunts predicted the occurrence of portal hypertension-related events.