Splenectomy prior to antiviral therapy in patients with hepatitis C virus related decompensated cirrhosis

11Citations
Citations of this article
15Readers
Mendeley users who have this article in their library.

Abstract

Patients with hepatitis C virus-related decompensated cirrhosis can benefit from interferon-based antiviral therapy, but the common complication of cytopenia is a contraindication for this treatment. Splenectomy prior to interferon therapy may alleviate this problem. To investigate whether splenectomy improves the efficacy of antiviral therapy, 13 interferon-naïve hepatitis C virus decompensated cirrhotic patients underwent splenectomy between January 2008 and January 2011, followed 1-3 months later by an interferon-based therapeutic regimen (pegylated/standard interferon-α combined with ribavirin for 48 weeks). Ten (76.9%) of the patients developed postoperative complications, which included minor portal vein thrombosis (2/13, 15.4%) and transient ascites (8/13, 61.5%). At one-month post-splenectomy, the patients showed significantly increased platelet (pre-surgery: 48.2±15.9 vs. 186.0±70.6×103μL-1, p<0.001) and leukocyte (2.1±0.5 vs. 5.7±1.4×103μL-1, p<0.001) counts. Eight (61.5%) of the patients achieved sustained virological response, including all HCV genotype 2a-infected patients (4/4, 100%) and some of the genotype 1b-infected patients (4/9, 44.4%). Temporary interferon-α suspension was required for one patient to address severe intestinal infection. These results indicate that splenectomy prior to interferon-based therapy was safe and may facilitate adherence to subsequent antiviral therapy in selected HCV cirrhotic patients with portal hypertension and hypersplenism. © 2013 Elsevier Editora Ltda.

Cite

CITATION STYLE

APA

Ji, F., Zhang, S., Huang, N., Deng, H., & Li, Z. (2013). Splenectomy prior to antiviral therapy in patients with hepatitis C virus related decompensated cirrhosis. Brazilian Journal of Infectious Diseases, 17(5), 601–605. https://doi.org/10.1016/j.bjid.2013.02.004

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free