Study Indicates Need for Non-invasive Testing for Hypertension During Post Hepatitis C Care

Direct-acting antivirals have high efficacy for hepatitis C, however, patients with advanced liver scarring are at risk for the development of secondary diseases.

Following the significant progress of antiviral drugs in treating chronic hepatitis C virus (HCV) over the past few years, a new study published in the Journal of Hepatology notes that hypertension is the major factor causing complications to develop in advanced liver disease. The study, led by Georg Semmler and Mattias Mandorfer from the Division of Gastroenterology and Hepatology at MedUni Vienna's Department of Medicine III, found that the non-invasive tests they previously analyzed accurately predicted the probability of sequelae.

This finding refutes concerns regarding how accurate these tests are and guides actions for individual disease follow-up. HCV has been successfully treated with direct antivirals, such as sofosbuvir, and can be cured in approximately 95% of cases; however, patients with advanced liver scarring are at risk for the development of secondary diseases. Such complications are attributed to high blood pressure in the large vein that moves blood from the gut to the liver.

The study authors examined all published data for to non-invasive tests and minimally invasive hepatic venous pressure gradient measurements conducted on patients prior to and following HCV treatment. The team analyzed paired measurements from 418 patients, which showed the accuracy of the non-invasive liver stiffness measurement and platelet count, which is a sample blood test.

A risk stratification system developed for patients after they’ve been successfully treated for HCV has been used to guide international recommendations for managing portal hypertension.

"The results of the study are therefore already contributing to the personalized follow-up of these patients worldwide, eliminating the need for unnecessary, sometimes burdensome examinations and enabling early initiation of preventive measures where appropriate," Semmler said in a press release.

For follow-up care post HCV treatment, the study authors noted that it is crucial to accurately identify portal hypertension via non-invasive testing.

"Our study has made it possible to accurately predict individual risk after hepatitis C has been cured. While it is possible to cease surveillance in a high proportion of patients, it is urgently recommended that preventive drug treatment is initiated or continued in others," Mandorfer said in a press release.

REFERENCE

Hepatitis C: study provides basis for personalised aftercare. Medical University of Vienna.November 3, 2022. Accessed November 4, 2022. https://www.meduniwien.ac.at/web/en/ueber-uns/news/2022/news-im-november-2022/hepatitis-c-studie-ermoeglicht-personalisierte-nachsorge/