von Willebrand factor antigen (vWF-Ag): A non-invasive predictor of treatment response and serious adverse events in HCV patients with interferon triple therapy

TY - JOUR

T1 - von Willebrand factor antigen (vWF-Ag): A non-invasive predictor of treatment response and serious adverse events in HCV patients with interferon triple therapy

AU - Horvatits (Rutter), Karoline

AU - Etschmaier, Alexandra

AU - Ferlitsch, Monika

AU - Maieron, Andreas

AU - Hametner, Stephanie

AU - Horvatits, Thomas

AU - Paternostro, Rafael

AU - Salzl, Petra

AU - Reiberger, Thomas

AU - Peck-Radosavljevic, Markus

AU - Quehenberger, Peter

AU - Hofer, Harald

AU - Trauner, Michael

AU - Ferenci, Peter

AU - Ferlitsch, Arnulf

N1 - Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

PY - 2016/10

Y1 - 2016/10

N2 - BACKGROUND: Treatment of chronic hepatitis C virus (HCV) infection was revolutionized within the last years. Interferon free antiviral regimens are not accessible without limitations. Combination of peginterferon/ribavirin with first generation direct acting antivirals is less effective and associated with serious adverse events.AIM: We have shown that vWF-Ag is associated with portal hypertension and treatment response to PEG/RBV and we evaluated if vWF-Ag is a predictive marker for treatment response and safety in patients with triple therapy.METHODS: 222 HCV-GT 1 patients and DAA based triple therapy were included in this retrospective, multicenter study.RESULTS: Median vWF-Ag levels were 167.0% [IQR: 124.0-210.0%]. Significantly higher levels were seen in patients without SVR; median 190% [IQR: 146.0-259.5%] versus SVR: 142.5% [IQR: 114.3-196.8%], p<0.001. Furthermore levels of vWF-Ag were identified as independent predictor of non SVR; (OR: 1.009; 95%CI: 1.016-1.3, p=0.005). In patients with cirrhosis elevated vWF-Ag levels were associated with increased incidence of SAEs (OR: 1.016; 95%CI: 1.004-1.028; p=0.007). Best cut off for prediction of SAEs was vWF-Ag>281.5% with a sensitivity of 78% and a specificity of 90%.CONCLUSION: Baseline vWF-Ag levels predict outcome of DAA based treatment in HCV-1 patients and identify patients with a risk of SAEs. Therefore vWF-Ag may be an additional marker for selecting patients for interferon free therapeutic regimens.

AB - BACKGROUND: Treatment of chronic hepatitis C virus (HCV) infection was revolutionized within the last years. Interferon free antiviral regimens are not accessible without limitations. Combination of peginterferon/ribavirin with first generation direct acting antivirals is less effective and associated with serious adverse events.AIM: We have shown that vWF-Ag is associated with portal hypertension and treatment response to PEG/RBV and we evaluated if vWF-Ag is a predictive marker for treatment response and safety in patients with triple therapy.METHODS: 222 HCV-GT 1 patients and DAA based triple therapy were included in this retrospective, multicenter study.RESULTS: Median vWF-Ag levels were 167.0% [IQR: 124.0-210.0%]. Significantly higher levels were seen in patients without SVR; median 190% [IQR: 146.0-259.5%] versus SVR: 142.5% [IQR: 114.3-196.8%], p<0.001. Furthermore levels of vWF-Ag were identified as independent predictor of non SVR; (OR: 1.009; 95%CI: 1.016-1.3, p=0.005). In patients with cirrhosis elevated vWF-Ag levels were associated with increased incidence of SAEs (OR: 1.016; 95%CI: 1.004-1.028; p=0.007). Best cut off for prediction of SAEs was vWF-Ag>281.5% with a sensitivity of 78% and a specificity of 90%.CONCLUSION: Baseline vWF-Ag levels predict outcome of DAA based treatment in HCV-1 patients and identify patients with a risk of SAEs. Therefore vWF-Ag may be an additional marker for selecting patients for interferon free therapeutic regimens.

KW - Journal Article

U2 - 10.1016/j.dld.2016.06.033

DO - 10.1016/j.dld.2016.06.033

M3 - SCORING: Journal article

C2 - 27476467

VL - 48

SP - 1194

EP - 1199

JO - DIGEST LIVER DIS

JF - DIGEST LIVER DIS

SN - 1590-8658

IS - 10

ER -