[Change in intraperitoneal shunt after DAA treatment for hepatitis C]
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Updated: May 5, 2026
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Published on: May 7, 2015
Michio Kubota1, Yasuharu Kikuchi1, Shintaro Kamimukai1
1Department of Gastroenterology, Numazu City Hospital.
Insights
Direct acting antiviral (DAA) treatment for hepatitis C virus-related cirrhosis can impact portal hypertension. The FIB4 index, a marker of liver fibrosis, was found to be the most significant factor in intraperitoneal shunt enlargement post-treatment.
Area of Science:
- Hepatology
- Radiology
- Virology
Context:
- Direct acting antiviral (DAA) treatments for hepatitis C virus (HCV)-related cirrhosis have shown variable effects on portal hypertension.
- Intraperitoneal shunts, a consequence of portal hypertension, are key indicators of disease progression and treatment response.
Purpose:
- To investigate changes in intraperitoneal shunt size following DAA treatment in patients with HCV-related cirrhosis.
- To identify factors influencing shunt modification, specifically enlargement, after achieving sustained virological response (SVR).
Summary:
- Eighty-three patients with HCV-related cirrhosis who achieved SVR with DAAs were analyzed using computed tomography (CT) scans before and after treatment.
- Intraperitoneal shunt enlargement (≥20% diameter change) was observed in 29 patients.
- Multivariate analysis identified the FIB4 index at the end of DAA treatment as the primary factor associated with shunt enlargement, suggesting fibrosis progression plays a role.
Impact:
- This study highlights the FIB4 index as a crucial predictor of intraperitoneal shunt changes after DAA therapy.
- Findings contribute to understanding the complex interplay between viral clearance, liver fibrosis, and portal hypertension management in HCV patients.
- Informs clinical decisions regarding monitoring and intervention for portal hypertension in patients undergoing DAA treatment.
Abstract:
Improvement and worsening of portal hypertension after direct acting antiviral agent (DAA) treatment for hepatitis C virus-related cirrhosis have been reported, and a consensus remains elusive. In this study, we underscored on the intraperitoneal shunt formed via portal hypertension and examined how the shunt system confirmed by computed tomography (CT) changes before and after treatment in cases in which sustained virological response (SVR) was attained with DAAs. Of the cases in which we achieved an SVR of 24 with DAA treatment for hepatitis C virus-related cirrhosis at our hospital, 83 cases in which CT images were taken before and after treatment were investigated. If the intraperitoneal shunt diameter changed by 20% or more, it was analyzed as an increase or decrease. In 29 patients, intraperitoneal shunt enlargement was noted. When examining factors related to the increase, multivariate analysis detected the FIB4 index at the end of the DAA treatment. Conversely, only four cases were observed in which the size decreased. At the end of treatment, the FIB4 index was the most important factor in increasing the intraperitoneal shunt after DAA treatment for hepatitis C virus-related cirrhosis, and fibrosis was believed to be an influencing factor.
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