{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:10:30Z","timestamp":1778821830754,"version":"3.51.4"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose\u2002Little evidence is available regarding the risk of hepatic decompensation (HD) after direct-acting antivirals (DAAs) in patients with advanced chronic liver disease. Our aim was to assess the risk of decompensation and the prognostic role of noninvasive tests, such as liver (LSM) and spleen (SSM) stiffness measurements, in the prediction of decompensation after sustained virologic response (SVR) by DAAs.<\/jats:p><jats:p>\n          Materials and Methods\u2002A cohort study involving 146 cirrhotic patients treated with DAAs in our tertiary center with LSM and SSM available both before and six months after treatment (SVR24). A historical cohort of 92 consecutive cirrhotic patients with active HCV was used as a control group.\u200aA propensity score inverse probability weighting method was used to account for differences between the groups. Time-dependent models for the prediction of decompensation were applied to account for changes in noninvasive tests after therapy.<\/jats:p><jats:p>\n          Results\u2002The decompensation incidence in the DAA cohort was 7.07 (4.56\u201310.96) per 100 person-years (PYs), which was significantly lower than in the active HCV cohort. The DAA therapy was an independent protective factor for HD development (SHR: 0.071, 95\u200a%-CI: 0.015\u20130.332). SSM \u2265\u200a54 kPa was independently associated with decompensation despite SVR achievement (SHR: 4.169, 95\u200a%-CI: 1.050\u201316.559), alongside with a history of decompensation (SHR: 7.956, 95\u200a%-CI: 2.556\u201324.762). SSM reduction &lt;\u200a10\u200a% also predicted the risk of decompensation after SVR24.<\/jats:p><jats:p>\n          Conclusion\u2002The risk of decompensation was markedly reduced after DAA therapy, but it was not eliminated. Paired SSM values stratified the risk of decompensation after SVR better than other noninvasive tests.<\/jats:p>","DOI":"10.1055\/a-1205-0367","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T22:58:06Z","timestamp":1594940286000},"page":"280-288","source":"Crossref","is-referenced-by-count":12,"title":["Spleen Stiffness Measurements Predict the Risk of Hepatic Decompensation After Direct-Acting Antivirals in HCV Cirrhotic Patients"],"prefix":"10.1055","volume":"43","author":[{"given":"Elton","family":"Dajti","sequence":"first","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Ravaioli","sequence":"first","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Gastroenterology, Integrated University Hospital of\u00a0Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Marasco","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Letizia","family":"Bacchi Reggiani","sequence":"additional","affiliation":[{"name":"DIMES, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agostino","family":"Colli","sequence":"additional","affiliation":[{"name":"Internal Medicine, Presidio Ospedaliero Alessandro Manzoni, Lecco, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigina Vanessa","family":"Alemanni","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariarosa","family":"Tam\u00e8","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Andreone","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Brillanti","sequence":"additional","affiliation":[{"name":"DSMCN, University of Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Azzaroli","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Mazzella","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Festi","sequence":"additional","affiliation":[{"name":"DIMEC, University of Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1053\/j.gastro.2016.05.049","article-title":"Effectiveness of Sofosbuvir, Ledipasvir\/Sofosbuvir, or Paritaprevir\/Ritonavir\/Ombitasvir and Dasabuvir Regimens for Treatment of Patients With Hepatitis C in the Veterans Affairs National Health Care System","volume":"151","author":"G N Ioannou","year":"2016","journal-title":"Gastroenterology"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1111\/jvh.12945","article-title":"Durability of virologic response, risk of de novo hepatocellular carcinoma, liver function and stiffness 2\u00a0years after treatment with ombitasvir\/paritaprevir\/ritonavir\u00b1dasabuvir\u00b1ribavirin in the AMBER, real-world experience study","volume":"25","author":"R Flisiak","year":"2018","journal-title":"J Viral Hepat"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1053\/j.gastro.2017.07.016","article-title":"Effects of All-oral Anti-viral Therapy on HVPG and Systemic Hemodynamics in Patients With Hepatitis C Virus-associated Cirrhosis","volume":"153","author":"S Lens","year":"2017","journal-title":"Gastroenterology"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.jhep.2018.03.026","article-title":"EASL Recommendations on Treatment of Hepatitis C 2018","volume":"69","author":"J M Pawlotsky","year":"2018","journal-title":"J Hepatol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jhep.2016.06.015","article-title":"Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals","volume":"65","author":"F Conti","year":"2016","journal-title":"J Hepatol"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1053\/j.gastro.2018.07.015","article-title":"Incidence of Hepatocellular Carcinoma After Direct Antiviral Therapy for HCV in Patients With Cirrhosis Included in Surveillance Programs","volume":"155","author":"P Nahon","year":"2018","journal-title":"Gastroenterology"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1016\/j.jhep.2018.07.024","article-title":"Development of Models Estimating the Risk of Hepatocellular Carcinoma After Antiviral Treatment for Hepatitis C","volume":"69","author":"G N Ioannou","year":"2018","journal-title":"J Hepatol"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1053\/j.gastro.2017.06.012","article-title":"Risk of Hepatocellular Cancer in HCV Patients Treated With Direct-Acting Antiviral Agents","volume":"153","author":"F Kanwal","year":"2017","journal-title":"Gastroenterology"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1053\/j.gastro.2018.10.033","article-title":"What are the Benefits of a Sustained Virologic Response to Direct-acting Antiviral Therapy for HCV Infection?","volume":"156","author":"G N Ioannou","year":"2019","journal-title":"Gastroenterology"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1002\/hep.30303","article-title":"Impact of all-oral direct-acting antivirals on clinical and economic outcomes in chronic hepatitis C patients in the U.S","volume":"69","author":"H Park","year":"2018","journal-title":"Hepatology"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jhep.2017.02.003","article-title":"Non invasive evaluation of portal hypertension using ultrasound elastography","volume":"67","author":"A Berzigotti","year":"2017","journal-title":"J Hepatol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","article-title":"Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension","volume":"63","author":"de Franchis R, Baveno VI Faculty","year":"2015","journal-title":"J Hepatol"},{"issue":"12","key":"ref13","doi-asserted-by":"crossref","first-page":"5221","DOI":"10.1007\/s00330-018-5478-z","article-title":"Comparison of three cut-offs to diagnose clinically significant portal hypertension by liver stiffness in chronic viral liver diseases: a meta-analysis","volume":"28","author":"J Song","year":"2018","journal-title":"Eur Radiol"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1111\/jgh.14271","article-title":"Accuracy of liver stiffness, spleen stiffness, and LS-spleen diameter to platelet ratio score in detection of esophageal varices: Systemic review and meta-analysis","volume":"33","author":"W Manatsathit","year":"2018","journal-title":"J Gastroenterol Hepatol"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.jhep.2018.04.023","article-title":"A combined model based on spleen stiffness measurement and Baveno VI criteria to rule out high-risk varices in advanced chronic liver disease","volume":"69","author":"A Colecchia","year":"2018","journal-title":"J Hepatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1016\/j.jhep.2014.02.024","article-title":"Spleen stiffness measurement can predict clinical complications in compensated HCV-related cirrhosis: A\u00a0prospective study","volume":"60","author":"A Colecchia","year":"2014","journal-title":"J Hepatol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/j.cgh.2013.07.034","article-title":"Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: a systematic review and meta-analysis","volume":"11","author":"S Singh","year":"2013","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1177\/1756283X17715198","article-title":"Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals","volume":"10","author":"M Pons","year":"2017","journal-title":"Therap Adv Gastroenterol"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1111\/jvh.12578","article-title":"Regression of fibrosis and portal hypertension in HCV-associated cirrhosis and sustained virologic response after interferon-free antiviral therapy","volume":"23","author":"V Knop","year":"2016","journal-title":"J Viral Hepat"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"731","DOI":"10.4254\/wjh.v10.i10.731","article-title":"Spleen stiffness mirrors changes in portal hypertension after successful interferon-free therapy in chronic-hepatitis C virus patients","volume":"10","author":"F Ravaioli","year":"2018","journal-title":"World J Hepatol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/sim.5984","article-title":"The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments","volume":"33","author":"P C Austin","year":"2014","journal-title":"Stat Med"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis","volume":"69","author":"P Angeli","year":"2018","journal-title":"J Hepatol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1055\/s-0043-103952","article-title":"EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version)","volume":"38","author":"C F Dietrich","year":"2017","journal-title":"Ultraschall in der Medizin"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jhep.2011.06.027","article-title":"Assessment of portal hypertension by\u00a0transient elastography in patients with compensated cirrhosis and potentially resectable liver tumors","volume":"56","author":"E Llop","year":"2012","journal-title":"J Hepatol"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.21037\/hbsn.2019.11.19","article-title":"Clinical outcomes after treatment with direct-acting antivirals: not all concern hepatocellular carcinoma risk","author":"E Dajti","year":"2019","journal-title":"Hepatobiliary Surg Nutr"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(18)32111-1","article-title":"Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study","volume":"393","author":"F Carrat","year":"2019","journal-title":"Lancet"},{"issue":"05","key":"ref27","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1002\/hep.29557","article-title":"Portal pressure and liver stiffness measurements in the prediction of fibrosis regression after SVR in recurrent hepatitis C","volume":"67","author":"E Mauro","year":"2018","journal-title":"Hepatology"},{"issue":"03","key":"ref28","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1002\/hep.30885","article-title":"Changes in HVPG predict hepatic decompensation in patients who achieved SVR to IFN\u2010free therapy","volume":"71","author":"M Mandorfer","year":"2020","journal-title":"Hepatology"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jhep.2018.10.018","article-title":"Noninvasive Response Prediction in Prophylactic Carvedilol Therapy for Cirrhotic Patients with Esophageal Varices","volume":"70","author":"H Y Kim","year":"2018","journal-title":"J Hepatol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.ultrasmedbio.2018.03.028","article-title":"A Novel FibroScan Examination Dedicated to Spleen Stiffness Measurement","volume":"44","author":"C Bastard","year":"2018","journal-title":"Ultrasound Med Biol"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1205-0367.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T15:06:54Z","timestamp":1660144014000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1205-0367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,16]]},"references-count":30,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,6,15]]},"published-print":{"date-parts":[[2022,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1205-0367","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,16]]}}}