Hepatitis C: Once the viral infection has healed, high-risk portal vein hypertension also diminishes

Hepatitis C is a common viral infection, which, up until a few years ago, was treated with interferon injections and additional drugs. Recovery rates were poor, particularly in patients with portal hypertension (high blood pressure in the portal vein that carries blood from the gut to the liver), and the side-effects were huge. In Austria today, people are treated directly with anti-viral drugs, which are largely free from side-effects and have a 95% success rate.

Although the hepatitis C virus can no longer be detected in people who have recovered, it was previously not known how reversible cirrhosis, and particularly portal vein hypertension, are. This is an important issue, because portal hypertension can result in bleeding from varicose veins in the esophagus or the development of ascites, or abdominal dropsy.

The research group headed by Peter Ferenci, Harald Hofer and Markus Peck-Radosavljevic of the Department of Gastroenterology and Hepatology (Director: Michael Trauner) have conducted portal vein pressure measurements on patients who have recovered with interferon-free treatment and, using a new method similar to ultrasound, they have observed that portal vein hypertension diminishes in the majority of patients, so long as hepatitis C has been treated at an early stage. This not only improves their prognosis but is also a relief for patients, because it means they can stop taking medications to prevent the complications of liver cirrhosis and therefore no longer have to put up with their side-effects. It also means that patients do not have to undergo stressful endoscopic check-ups quite as often. Non-invasive ultrasound procedures can prospectively also be used to establish whether portal vein hypertension has diminished in individual patients.

Mattias Mandorfer: "As a general rule, the probability of portal vein hypertension diminishing is greater, the earlier treatment was started. However, despite the promising results, we still strongly recommend that patients attend for check-ups, because portal vein hypertension does not diminish in all patients and, irrespective of whether it does or does not, there is a risk of developing liver cancer as a result of cirrhosis."