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Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance

The predictive factors of long-term clinical benefits in patients with hepatitis C virus (HCV)—related liver cirrhosis after Direct Antiviral Agents (DAA) treatment are still undefined. The aim of this study was to identify any predictors of liver failure, hepatocellular carcinoma (HCC) and/or death...

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Autores principales: Franzè, Maria Stella, Filomia, Roberto, Caccamo, Gaia, Pitrone, Concetta, Alibrandi, Angela, Saitta, Carlo, Caspanello, Amalia Rita, Asero, Clelia, Arcadi, Vittoria, Raimondo, Giovanni, Cacciola, Irene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699534/
https://www.ncbi.nlm.nih.gov/pubmed/36579534
http://dx.doi.org/10.3390/jpm12111794
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author Franzè, Maria Stella
Filomia, Roberto
Caccamo, Gaia
Pitrone, Concetta
Alibrandi, Angela
Saitta, Carlo
Caspanello, Amalia Rita
Asero, Clelia
Arcadi, Vittoria
Raimondo, Giovanni
Cacciola, Irene
author_facet Franzè, Maria Stella
Filomia, Roberto
Caccamo, Gaia
Pitrone, Concetta
Alibrandi, Angela
Saitta, Carlo
Caspanello, Amalia Rita
Asero, Clelia
Arcadi, Vittoria
Raimondo, Giovanni
Cacciola, Irene
author_sort Franzè, Maria Stella
collection PubMed
description The predictive factors of long-term clinical benefits in patients with hepatitis C virus (HCV)—related liver cirrhosis after Direct Antiviral Agents (DAA) treatment are still undefined. The aim of this study was to identify any predictors of liver failure, hepatocellular carcinoma (HCC) and/or death in patients with compensated liver cirrhosis who achieved the sustained virological response (SVR). To this purpose, 324 consecutive cirrhotic patients who started DAA treatment from 1 April 2015 to 31 December 2016 were retrospectively analyzed. All patients were followed up for a median time of 63 months (range 19–77) through clinical/biochemical/instrumental examinations performed at baseline and after stopping the DAA treatment. At the end of the evaluation, 230 (71%) individuals showed stable clinical liver disease over time, 43 (13.3%) developed HCC, and 24 (7.4%) developed hepatic decompensation without HCC. Overall, 49 (15,1%) patients died. Multivariate regression analysis showed that hepatic decompensation was significantly associated with at baseline older age, higher liver stiffness, higher spleen longitudinal size values and hypergammaglobulinemia (p = 0.003, p = 0.005, p = 0.001, p = 0.029, respectively). HCC development was significantly associated with hypergammaglobulinemia (p < 0.001). Death was associated with older age and hypergammaglobulinemia (p < 0.001 and p = 0.007, respectively). Finally, survival analysis confirmed that patients with gamma globulin levels ≥ 1.8 gr/dl had a significantly higher risk of death compared to those with gamma globulin levels < 1.8 gr/dl (p < 0.001). In conclusion, hypergammaglobulinemia before starting DAA therapy represents a strong predictor of hepatic decompensation, HCC and death in cirrhotic patients even after HCV clearance.
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spelling pubmed-96995342022-11-26 Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance Franzè, Maria Stella Filomia, Roberto Caccamo, Gaia Pitrone, Concetta Alibrandi, Angela Saitta, Carlo Caspanello, Amalia Rita Asero, Clelia Arcadi, Vittoria Raimondo, Giovanni Cacciola, Irene J Pers Med Article The predictive factors of long-term clinical benefits in patients with hepatitis C virus (HCV)—related liver cirrhosis after Direct Antiviral Agents (DAA) treatment are still undefined. The aim of this study was to identify any predictors of liver failure, hepatocellular carcinoma (HCC) and/or death in patients with compensated liver cirrhosis who achieved the sustained virological response (SVR). To this purpose, 324 consecutive cirrhotic patients who started DAA treatment from 1 April 2015 to 31 December 2016 were retrospectively analyzed. All patients were followed up for a median time of 63 months (range 19–77) through clinical/biochemical/instrumental examinations performed at baseline and after stopping the DAA treatment. At the end of the evaluation, 230 (71%) individuals showed stable clinical liver disease over time, 43 (13.3%) developed HCC, and 24 (7.4%) developed hepatic decompensation without HCC. Overall, 49 (15,1%) patients died. Multivariate regression analysis showed that hepatic decompensation was significantly associated with at baseline older age, higher liver stiffness, higher spleen longitudinal size values and hypergammaglobulinemia (p = 0.003, p = 0.005, p = 0.001, p = 0.029, respectively). HCC development was significantly associated with hypergammaglobulinemia (p < 0.001). Death was associated with older age and hypergammaglobulinemia (p < 0.001 and p = 0.007, respectively). Finally, survival analysis confirmed that patients with gamma globulin levels ≥ 1.8 gr/dl had a significantly higher risk of death compared to those with gamma globulin levels < 1.8 gr/dl (p < 0.001). In conclusion, hypergammaglobulinemia before starting DAA therapy represents a strong predictor of hepatic decompensation, HCC and death in cirrhotic patients even after HCV clearance. MDPI 2022-10-31 /pmc/articles/PMC9699534/ /pubmed/36579534 http://dx.doi.org/10.3390/jpm12111794 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Franzè, Maria Stella
Filomia, Roberto
Caccamo, Gaia
Pitrone, Concetta
Alibrandi, Angela
Saitta, Carlo
Caspanello, Amalia Rita
Asero, Clelia
Arcadi, Vittoria
Raimondo, Giovanni
Cacciola, Irene
Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance
title Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance
title_full Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance
title_fullStr Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance
title_full_unstemmed Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance
title_short Hypergammaglobulinemia before Starting DAA Therapy Is A Strong Predictor of Disease Progression in Cirrhotic Patients Even after HCV Clearance
title_sort hypergammaglobulinemia before starting daa therapy is a strong predictor of disease progression in cirrhotic patients even after hcv clearance
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9699534/
https://www.ncbi.nlm.nih.gov/pubmed/36579534
http://dx.doi.org/10.3390/jpm12111794
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