Antiviral therapy reduces portal pressure in patients with cirrhosis due to HBeAg-negative chronic hepatitis B and significant portal hypertension

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J Hepatol. 2009 Jul 3. [Epub ahead of print]

Antiviral therapy reduces portal pressure in patients with cirrhosis due to

HBeAg-negative chronic hepatitis B and significant portal hypertension.

Manolakopoulos S, Triantos C, Theodoropoulos J, Vlachogiannakos J, Kougioumtzan

A, Papatheodoridis G, Tzourmakliotis D, Karamanolis D, Burroughs AK,

Archimandritis A, Raptis S, Avgerinos A.

Department of Gastroenterology, Polyclinic General Hospital, Athens, Greece; 2nd

Department of Internal Medicine, University of Athens Medical School, Athens,

Greece.

BACKGROUND/AIMS: Lamivudine improves liver histology in patients with chronic

hepatitis B (CHB), but its effects on portal pressure remain unknown. We

evaluated the effect of lamivudine monotherapy on hepatic venous pressure

gradient (HVPG) in CHB-related cirrhosis with significant portal hypertension.

METHODS: We studied 19 patients with cirrhosis due to HBeAg-negative CHB and

HVPG 10mmHg treated with oral lamivudine (100mg daily). Liver biochemistry,

Child-Pugh and MELD score were determined every 3 months, alpha-fetoprotein and

HBV DNA every 6 months and HVPG at baseline and at 12 months after lamivudine

initiation. Diuretics, beta-blockers, antibiotics and/or endoscopic therapy were

used for routine indications. RESULTS: At 12 months, a significant reduction was

observed in ALT (p=0.001), HBV DNA (p=0.002), Child-Pugh (p=0.012) and MELD

score (p=0.006). Four patients developed virological breakthrough during

treatment. At 12 months, HVPG decreased in all but one patient [baseline:

14.4+/-3.9 and 12 months: 12.4+/-3.3mmHg (p=0.007)]. HVPG decreased>20% or below

the 12mmHg threshold in 10 of 13 patients with baseline HVPG 12mmHg. HVPG

increased in a patient with hepatic flare after virological breakthrough.

CONCLUSION: In conclusion, in patients with cirrhosis due to HBeAg-negative CHB,

lamivudine monotherapy reduces HVPG, especially when virological suppression and

biochemical remission is achieved.

PMID: 19616339 [PubMed - as supplied by publisher]

[Guest guest]

J Hepatol. 2009 Jul 3. [Epub ahead of print]

Antiviral therapy reduces portal pressure in patients with cirrhosis due to

HBeAg-negative chronic hepatitis B and significant portal hypertension.

Manolakopoulos S, Triantos C, Theodoropoulos J, Vlachogiannakos J, Kougioumtzan

A, Papatheodoridis G, Tzourmakliotis D, Karamanolis D, Burroughs AK,

Archimandritis A, Raptis S, Avgerinos A.

Department of Gastroenterology, Polyclinic General Hospital, Athens, Greece; 2nd

Department of Internal Medicine, University of Athens Medical School, Athens,

Greece.

BACKGROUND/AIMS: Lamivudine improves liver histology in patients with chronic

hepatitis B (CHB), but its effects on portal pressure remain unknown. We

evaluated the effect of lamivudine monotherapy on hepatic venous pressure

gradient (HVPG) in CHB-related cirrhosis with significant portal hypertension.

METHODS: We studied 19 patients with cirrhosis due to HBeAg-negative CHB and

HVPG 10mmHg treated with oral lamivudine (100mg daily). Liver biochemistry,

Child-Pugh and MELD score were determined every 3 months, alpha-fetoprotein and

HBV DNA every 6 months and HVPG at baseline and at 12 months after lamivudine

initiation. Diuretics, beta-blockers, antibiotics and/or endoscopic therapy were

used for routine indications. RESULTS: At 12 months, a significant reduction was

observed in ALT (p=0.001), HBV DNA (p=0.002), Child-Pugh (p=0.012) and MELD

score (p=0.006). Four patients developed virological breakthrough during

treatment. At 12 months, HVPG decreased in all but one patient [baseline:

14.4+/-3.9 and 12 months: 12.4+/-3.3mmHg (p=0.007)]. HVPG decreased>20% or below

the 12mmHg threshold in 10 of 13 patients with baseline HVPG 12mmHg. HVPG

increased in a patient with hepatic flare after virological breakthrough.

CONCLUSION: In conclusion, in patients with cirrhosis due to HBeAg-negative CHB,

lamivudine monotherapy reduces HVPG, especially when virological suppression and

biochemical remission is achieved.

PMID: 19616339 [PubMed - as supplied by publisher]