REDUCTION OF SPLENIC VOLUME AFTER DIRECT ACTING ANTIVIRALS TREATMENT IN PATIENTS WITH HCV COMPENSATED CIRRHOSIS
Abstract
The aim of this study was to evaluate the impact of direct-acting antivirals (DAAs) treatment on spleen size and portal circulation after the achievement of sustained virological response (SVR) in patients with hepatitis C virus (HCV)-related cirrhosis. Material and methods: CT examination was performed in 60 patients with HCV-related compensated cirrhosis before and within 6-18 months after the treatment with Ombitasvir/ Paritaprevir/ ritonavir + Dasabuvir. The CT changes of spleen were assessed by measuring spleen volume. Portal trunk, splenic and superior mesenteric vein diameters have been assessed as part of portal hypertension. Results: Splenic volume was considerably higher before treatment (median: 564.79 mm3, IQR: 342.54) than after (median: 474.45 mm3, IQR: 330.00), z=-2.500, p=0.012. The portal vessels diameters showed no significant changes. Conclusions: There is a statistically significant reduction in size of spleen in patients with HCV-related compensated cirrhosis who achieved SVR after treatment with DAAs and this can be used as a sensitive imaging marker to assess improvement in cirrhotic patient’s condition.
References
2. Tarantino G. Liver-spleen axis: Intersection between immunity, infections and metabolism. World J Gastroenterol 2013; 19(23): 3534.
3. Keramida G, Dunford A, Kaya G, Anagnostopoulos CD, Peters AM. Hepato-splenic axis: hepatic and splenic metabolic activities are linked. Am J Nucl Med Mol Imaging 2018; 8(3): 228-238.
4. Berzigotti A, Zappoli P, Magalotti D, Tiani C, Rossi V, Zoli M. Spleen Enlargement on Follow-Up Evaluation: A Noninvasive Predictor of Complications of Portal Hypertension in Cirrhosis. Clin Gas-troenterol Hepatol 2008; 6(10): 1129-1134.
5. Shah SHA, Hayes PC, Allan PL, Nicoll J, Finlayson ND. Measurement of spleen size and its relation to hypersplenism and portal hemodynamics in portal hypertension due to hepatic cirrhosis. Am J Gas-troenterol 1996; 91(12): 2580-2583.
6. Bolognesi M, Merkel C, Sacerdoti D, Nava V, Gatta A. Role of spleen enlargement in cirrhosis with portal hypertension. Dig Liver Dis 2002; 34(2): 144-150.
7. Benoit J, Granger D. Splanchnic Hemodynamics in Chronic Portal Hypertension. Semin Liver Dis 1986; 6(04): 287-298.
8. Asanoma M, Ikemoto T, Mori H, et al. Cytokine expression in spleen affects progression of liver cirrhosis through liver-spleen cross-talk. Hepatol Res 2014; 44(12): 1217-1223.
9. Yamada S, Morine Y, Imura S, et al. Liver regeneration after splenectomy in patients with liver cir-rhosis. Hepatol Res 2016; 46(5): 443-449.
10. Lok AS, Chung RT, Vargas HE, Kim AY, Naggie S, Powderly WG. Benefits of Direct-Acting Anti-virals for Hepatitis C. Ann Intern Med 2017; 167(11): 812.
11. Grgurevic I, Bozin T, Madir A. Hepatitis C is now curable, but what happens with cirrhosis and portal hypertension afterwards? Clin Exp Hepatol 2017; 4(4): 181-186.
12. Mihai F, Trifan A, Cuciureanu T, Negru D, Sîngeap A. Role of Computed Tomography in The Eval-uation of The Patients With Hepatitis C-Related Liver Cirrhosis. Rev Med Chir Soc Med Nat Iasi 2017; 121(3): 535-547.
13. Liu P, Li P, He W, Zhao L-Q. Liver and spleen volume variations in patients with hepatic fibrosis. World J Gastroenterol 2009; 15(26): 3298.
14. Zhang Y, Zhang XM, Prowda JC, et al. Changes in hepatic venous morphology with cirrhosis on MRI. J Magn Reson Imaging 2009; 29(5): 1085-1092.
15. Mihai F, Trifan A, Stanciu C, et al. Liver Remodeling on CT Examination in Patients with HCV Compensated Cirrhosis Who Achieved Sustained Virological Response after Direct-Acting Antivirals Treatment. Medicina 2020; 56(4): 171.
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