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Background <p>Direct-acting-antivirals (DAAs) achieve high sustained-virologic response (SVR) rates, even in patients with hepatitis C virus (HCV)-related decompensated liver cirrhosis (LC). However, predictors of post-treatment liver function improvement and survival remain unclear. This study evaluated pretreatment angiopoietin-2 (Ang2) levels as a predictor of prognosis and liver functional reserve after DAA treatment.</p> Methods <p>This multicenter retrospective study included 123 patients with HCV-related decompensated LC treated with sofosbuvir/velpatasvir. Serum Ang2 levels were quantified, and liver function was assessed using the Child–Pugh grading at baseline and 12&#xa0;weeks after the end of treatment (SVR12). Factors associated with prognosis and post-SVR liver functional reserve (Child–Pugh grade C) were investigated.</p> Results <p>Multivariate Cox regression analysis revealed that, in addition to age and creatinine levels at SVR12, baseline Ang2 levels (hazard ratio [HR] = 1.151 per 1000&#xa0;pg/mL, <i>P</i> = 0.033) and Child–Pugh grade C at SVR12 (HR = 11.765, <i>P</i> &lt; 0.001), but not baseline Child–Pugh grade C, were significantly associated with the overall survival. Multivariate analysis revealed that baseline Ang2 levels and baseline Child–Pugh grade C were significantly and independently associated with Child–Pugh grade C at SVR12. The combination of elevated baseline Ang2 levels (≥ 8684&#xa0;pg/mL; 1 point) and baseline Child–Pugh grade C (1 point) effectively stratified patients with a high likelihood of having Child–Pugh Grade C at SVR12. The incidence rates were as follows: 0 points, 2.1% (2/96); 1 point, 37.5% (9/24); and 2 points, 100% (2/2) (<i>P</i> &lt; 0.001).</p> Conclusions <p>Pretreatment Ang2 levels predict survival and liver functional reserve after SVR in HCV-related decompensated LC.</p> Graphical abstract <p></p>

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Pretreatment serum angiopoietin-2 predicts prognosis and liver functional reserve after successful HCV eradication with sofosbuvir and velpatasvir in patients with HCV-related decompensated cirrhosis

  • 期刊论文

  • 发表日期：

    2025年6月20日

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  • Naoki Kawagishi,
  • Goki Suda,
  • Yuki Tahata,
  • Hayato Hikita,
  • Takahiro Kodama,
  • Satoshi Mochida,
  • Nobuyuki Enomoto,
  • Seiichi Mawatari,
  • Hidekatsu Kuroda,
  • Daiki Miki,
  • Masayuki Kurosaki,
  • Yoichi Hiasa,
  • Norifumi Kawada,
  • Taro Yamashita,
  • Hiroshi Yatsuhashi,
  • Hitoshi Yoshiji,
  • Naoya Kato,
  • Taro Takami,
  • Hisamitsu Miyaaki,
  • Kentaro Matsuura,
  • Yasuhiro Asahina,
  • Yoshito Itoh,
  • Ryosuke Tateishi,
  • Yasunari Nakamoto,
  • Eiji Kakazu,
  • Shuji Terai,
  • Masahito Shimizu,
  • Yoshiyuki Ueno,
  • Norio Akuta,
  • Masatsugu Ohara,
  • Naoya Sakamoto,
  • Tetsuo Takehara

摘要

Background

Direct-acting-antivirals (DAAs) achieve high sustained-virologic response (SVR) rates, even in patients with hepatitis C virus (HCV)-related decompensated liver cirrhosis (LC). However, predictors of post-treatment liver function improvement and survival remain unclear. This study evaluated pretreatment angiopoietin-2 (Ang2) levels as a predictor of prognosis and liver functional reserve after DAA treatment.

Methods

This multicenter retrospective study included 123 patients with HCV-related decompensated LC treated with sofosbuvir/velpatasvir. Serum Ang2 levels were quantified, and liver function was assessed using the Child–Pugh grading at baseline and 12 weeks after the end of treatment (SVR12). Factors associated with prognosis and post-SVR liver functional reserve (Child–Pugh grade C) were investigated.

Results

Multivariate Cox regression analysis revealed that, in addition to age and creatinine levels at SVR12, baseline Ang2 levels (hazard ratio [HR] = 1.151 per 1000 pg/mL, P = 0.033) and Child–Pugh grade C at SVR12 (HR = 11.765, P < 0.001), but not baseline Child–Pugh grade C, were significantly associated with the overall survival. Multivariate analysis revealed that baseline Ang2 levels and baseline Child–Pugh grade C were significantly and independently associated with Child–Pugh grade C at SVR12. The combination of elevated baseline Ang2 levels (≥ 8684 pg/mL; 1 point) and baseline Child–Pugh grade C (1 point) effectively stratified patients with a high likelihood of having Child–Pugh Grade C at SVR12. The incidence rates were as follows: 0 points, 2.1% (2/96); 1 point, 37.5% (9/24); and 2 points, 100% (2/2) (P < 0.001).

Conclusions

Pretreatment Ang2 levels predict survival and liver functional reserve after SVR in HCV-related decompensated LC.

Graphical abstract