The impact of sustained virological response (SVR) on the criteria used to rule out high risk esophageal varices (HRV) in HCV-related compensated advanced chronic liver disease (cACLD)

Abstract

Background: Baveno VI criteria [platelet count (plt) >150 × 109/l and liver stiffness measurement (LSM) <20 KPa] to rule out high risk esophageal varices (HRV) in chronic advanced viral-related liver disease (cACLD) perform efficiently in viremic patients. Further refinements of these criteria [Expanded Baveno VI criteria (Plt110/LSM25), or Plt125/LSM25 criteria] maintain high accuracy sparing more endoscopies. The Plt150/MELD6 criteria are less accurate in viremic cACLD patients. How sustained virological response (SVR) achieved by direct-acting antivirals (DAA) impacts on such criteria is unknown. We assessed the performance of Expanded Baveno VI, Plt125/LSM25 and PLT150/MELD6 criteria, compared to the original Baveno VI criteria, to rule out HRV in 192 HCV-related cACLD patients with an SVR to DAAs.