{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:00:58Z","timestamp":1790719258519,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Risk stratification after cure from hepatitis C virus (HCV) infection remains a clinical challenge. We investigated the predictive value of noninvasive surrogates of portal hypertension (liver stiffness measurement [LSM] by vibration\u2010controlled transient elastography and von Willebrand factor\/platelet count ratio [VITRO]) for development of hepatic decompensation and hepatocellular carcinoma in patients with pretreatment advanced chronic liver disease (ACLD) who achieved HCV cure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>A total of 276 patients with pretreatment ACLD and information on pretreatment and posttreatment follow\u2010up (FU)\u2010LSM and FU\u2010VITRO were followed for a median of 36.6\u00a0months after the end of interferon\u2010free therapy. FU\u2010LSM (area under the receiver operating characteristic curve [AUROC]: 0.875 [95% confidence interval [CI]: 0.796\u20100.954]) and FU\u2010VITRO (AUROC: 0.925 [95% CI: 0.874\u20100.977]) showed an excellent predictive performance for hepatic decompensation. Both parameters provided incremental information and were significantly associated with hepatic decompensation in adjusted models. A previously proposed combined approach (FU\u2010LSM\u00a0&lt;\u00a012.4\u00a0kPa and\/or FU\u2010VITRO\u00a0&lt;\u00a00.95) to rule out clinically significant portal hypertension (CSPH, hepatic venous pressure gradient \u226510\u00a0mm\u00a0Hg) at FU assigned most (57.3%) of the patients to the low\u2010risk group; none of these patients developed hepatic decompensation. In contrast, in patients in whom FU\u2010CSPH was ruled in (FU\u2010LSM\u00a0&gt;\u00a025.3\u00a0kPa and\/or FU\u2010VITRO\u00a0&gt;\u00a03.3; 25.0% of patients), the risk of hepatic decompensation at 3\u00a0years following treatment was high (17.4%). Patients within the diagnostic gray\u2010zone for FU\u2010CSPH (17.8% of patients) had a very low risk of hepatic decompensation during FU (2.6%). The prognostic value of this algorithm was validated in an internal (n\u00a0=\u00a086) and external (n\u00a0=\u00a0162) cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>FU\u2010LSM\/FU\u2010VITRO are strongly and independently predictive of posttreatment hepatic decompensation in HCV\u2010induced ACLD. An algorithm combining these noninvasive markers not only rules in or rules out FU\u2010CSPH, but also identifies populations at negligible versus high risk for hepatic decompensation. FU\u2010LSM\/FU\u2010VITRO are readily accessible and enable risk stratification after sustained virological response, and thus facilitate personalized management.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31462","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T17:35:23Z","timestamp":1594661723000},"page":"1275-1289","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":69,"title":["Noninvasive Risk Stratification After HCV Eradication in Patients With Advanced Chronic Liver Disease"],"prefix":"10.1097","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-166X","authenticated-orcid":false,"given":"Georg","family":"Semmler","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9930-2767","authenticated-orcid":false,"given":"Teresa","family":"Binter","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Kozbial","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-8076","authenticated-orcid":false,"given":"Philipp","family":"Schwabl","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hametner\u2010Schreil","sequence":"additional","affiliation":[{"name":"Internal Medicine IV,Ordensklinikum Linz Barmherzige Schwestern,Linz,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Zanetto","sequence":"additional","affiliation":[{"name":"Gastroenterology and Multivisceral Transplant Unit,Department of Surgery, Oncology, and Gastroenterology,Padua University Hospital,Padua,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Gavasso","sequence":"additional","affiliation":[{"name":"General Internal Medicine and Thrombotic and Hemorrhagic Diseases Unit,Department of Medicine,Padua University Hospital,Padua,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1807-8258","authenticated-orcid":false,"given":"David","family":"Chromy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-8518","authenticated-orcid":false,"given":"David J.M.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9146","authenticated-orcid":false,"given":"Benedikt","family":"Simbrunner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4904-5133","authenticated-orcid":false,"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3901-4111","authenticated-orcid":false,"given":"Theresa","family":"Bucsics","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of Vienna,Vienna,Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert F.","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine III,Medical University of Vienna,Vienna,Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory,Medical University of 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