Higher Liver Volume is a Non-Invasive Indicator of Hepatic Reserve in Cirrhotic Patients Undergoing Treatment for Hepatitis C Virus Infection

Abstract

BACKGROUND: Nearly all patients with hepatitis C virus (HCV) infection can be treated successfully and achieve a virolgical cure; however, cure does not ensure the return of normal liver function. Non-invasive markers are needed to identify patients at high risk for continued liver dysfunction despite HCV cure. OBJECTIVES: To evaluate liver volume, spleen volume, and model for end-stage liver disease (MELD) score prior to treatment as predictors of continued liver dysfunction post-cure. METHODS: Multivariable logistic regression was used to identify factors associated with post-cure liver dysfunction, defined as serum albumin below the lower limit of normal. Liver and spleen volumes were calculated from computed tomography (CT) and magnetic resonance images (MRI). RESULTS: One-predictor logistic regression models revealed that greater pre-treatment liver volume per ideal body weight [odds ratio (OR): 1.2 per mL/kg, p=0.008], lower pre-treatment spleen volume per ideal body weight (OR: 0.89 for every mL/kg, p=0.032), and lower pre-treatment MELD score (OR: 0.56 for every 1 unit increase in MELD score, p=0.002) were significantly related to recovery (albumin normalization). SIGNIFICANCE: Liver volume, spleen volume, and the MELD score may all help to identify high-risk patients