학술논문
ALBI score predicts morphological changes in esophageal varices following direct-acting antiviral-induced sustained virological response in patients with liver cirrhosis
Document Type
Original Paper
Author
Atsukawa, Masanori; Tsubota, Akihito; Kondo, Chisa; Toyoda, Hidenori; Takaguchi, Koichi; Nakamuta, Makoto; Watanabe, Tsunamasa; Morishita, Asahiro; Tani, Joji; Okubo, Hironao; Hiraoka, Atsushi; Nozaki, Akito; Chuma, Makoto; Kawata, Kazuhito; Uojima, Haruki; Ogawa, Chikara; Asano, Toru; Mikami, Shigeru; Kato, Keizo; Matsuura, Kentaro; Ikegami, Tadashi; Ishikawa, Toru; Tsuji, Kunihiko; Tada, Toshifumi; Tsutsui, Akemi; Senoh, Tomonori; Kitamura, Michika; Okubo, Tomomi; Arai, Taeang; Kohjima, Motoyuki; Morita, Kiyoshi; Akahane, Takehiro; Nishikawa, Hiroki; Iwasa, Motoh; Tanaka, Yasuhito; Iwakiri, Katsuhiko
Source
Journal of Gastroenterology. :1-10
Subject
Language
English
ISSN
0944-1174
1435-5922
1435-5922
Abstract
Background: This study aimed to clarify the morphological changes in esophageal varices after achieving sustained virological response (SVR) with direct-acting antivirals (DAAs) in patients with cirrhosis.Methods: A total of 243 patients underwent esophagogastroduodenoscopy before DAA treatment and after achieving SVR. Morphological changes in esophageal varices were investigated using esophagogastroduodenoscopy.Results: This study comprised 125 males and 118 females with a median age of 68 years. Esophageal varices at baseline were classified into no varix in 155 (63.8%), F1 in 59 (24.3%), F2 in 25 (10.3%) and F3 in 4 (1.6%) patients. The improvement, unchanged, and aggravation rates of esophageal varices after SVR were 11.9%, 73.3%, and 14.8%, respectively. High ALBI score at SVR12 was an independent factor associated with post-SVR esophageal varices aggravation (p = 0.045). Time-dependent receiver operating characteristic (ROC) curve analysis revealed a cut-off value of − 2.33 for ALBI score at SVR12 in predicting post-SVR esophageal varices aggravation. Of the 155 patients without esophageal varices at baseline, 17 developed de novo post-SVR esophageal varices. High ALBI score at SVR12 was a significant independent factor associated with de novo post-SVR esophageal varices (p = 0.046). ROC curve analysis revealed a cut-off value of − 2.65 for ALBI score at SVR12 in predicting de novo post-SVR esophageal varices.Conclusions: Patients with cirrhosis can experience esophageal varices aggravation or de novo esophageal varices, despite achieving SVR. In particular, patients with high ALBI score at SVR12 have a high likelihood of developing post-SVR esophageal varices aggravation or de novo post-SVR esophageal varices.