Post-SVR ALBI score predicts esophageal varices development and progression in patients with cirrhosis

Abstract

This study aimed to clarify the morphological changes in esophageal varices after achieving sustained virological response (SVR) with direct-acting antivirals (DAAs) in patients with cirrhosis.

A total of 243 patients underwent esophagogastroduodenoscopy before DAA treatment and after achieving SVR. Morphological changes in esophageal varices were investigated using esophagogastroduodenoscopy. The improvement, unchanged, and aggravation rates of esophageal varices after SVR were 11.9%, 73.3%, and 14.8%, respectively.

ALBI score at the time of SVR12 was independently associated with both worsening of existing varices and the development of newly formed varices (p=0.045 and p=0.046, respectively). ROC curve analysis revealed that the optimal ALBI score cutoff values for predicting worsening and newly developed EVs after SVR were -2.33 and -2.65, respectively.

In conclusion, patients with liver cirrhosis may still develop worsening or newly formed EVs even after achieving SVR. In particular, patients with poor ALBI scores at SVR12 are at higher risk, and regular endoscopic evaluation should be considered in this population.