Pol. Merkur. Lek (Pol. Med. J.), 2019, XLVI/275: 209-212

SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

Mild hyperbilirubinemia as a marker of oesophageal varices in HCV-related compensated cirrhotic patients

Mikuła T, Suchacz MM, Stańczak W, Jabłońska J, Kozłowska J, Cybula A, Cianciara J, Wiercińska-Drapało A.

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland

The natural course of compensated liver cirrhosis caused by chronic hepatitis C virus (HCV) infection is still a very interesting problem in hepatology. The prognostic usefulness of the Child-Pugh and MELD score in compensated liver cirrhosis is still debated. Consequently, several attempts have been made to determine parameters other than included in the Child-Pugh score, which could be helpful in the prognosis of compensated liver cirrhosis assessment.
The aim of study was to identify a clinical or laboratory markers correlated with higher risk of liver decompensation among HCVinfected patients with compensated liver cirrhosis and presence or absence of esophageal varices.
Material and methods. The study included 176 HCV-infected patients with compensated liver cirrhosis (74 women and 102 men) registered in the Clinical Database of Patients with Liver Cirrhosis – e-Hepar. All patients were monitored during 252 weeks for the occurrence of liver failure symptoms and the development of hepatocellular carcinoma (HCC).
Results. The presence of esophageal varices was significantly associated with total bilirubin ≥2.0 mg/dl, platelets ≤110.0 G/L and 6 points in Child-Pugh score (p<0.05). The cumulative 252 weeks incidence of clinical decompensation was higher in patients with varices in comparison to patients without them (p<0.05). Variceal hemorrhages were observed in 9 cases (23.1%). During the follow-up period 9 patients died due to HCC complications.
Conclusions. Our findings underline the prognostic value of serum bilirubin (even mild elevation) and platelet count in HCV-infected patients with compensated liver cirrhosis. We have confirmed that liver decompensation is more frequent and more rapid in patients with compensated liver disease and concomitant oesophageal varices.

Key words: liver, compensated cirrhosis, HCV, oesophageal varices, hyperbilirubinemia

Pol Med J, 2019; XLVI (275); 209–212