Partial splenic embolization for the treatment of hypersplenism in cirrhotic HIV/HCV patients prior to pegylated interferon and ribavirin.

Published

Journal Article

Partial splenic embolization (PSE), a non-surgical treatment for hypersplenism, has also been reported to improve hepatic function. As severe thrombocytopaenia or leukopaenia contraindicate the use of combined therapy with pegylated interferons (PEG-IFNs) and ribavirin (RBV) in HCV-related cirrhosis, we evaluated, from July 2002 to October 2003, the safety and effectiveness of PSE as a procedure to allow therapy for HCV in three Child-Pugh class B cirrhotic patients with hypersplenism and HIV co-infection. HCV genotypes were 1b (n=2) and 3a (n=1). Severe thrombocytopaenia (in all) and leukopaenia (in two) precluded therapy for HCV. PSE was successfully performed in all with a mean infarcted area of 80%, leading to a significant increase in platelet and leukocyte counts that allowed therapy with weight-adjusted RBV and PEG-IFN-alpha-2b (patients 1 and 3) or 180 microg of PEG-IFN-alpha-2a (patient 2) 8 weeks after the procedure. Moderate pain, well controlled with conservative measures, followed PSE in 100% of cases, but during follow-up (mean 422 days) there were no infectious complications or liver decompensation episodes. Although preliminary, these results suggest the potential role of PSE in HIV/HCV-cirrhotic subjects with hypersplenism as a procedure to allow the use of combined PEG-IFN and RBV.

Full Text

Cited Authors

  • Moreno, A; Bárcena, R; Blázquez, J; Quereda, C; Gil-Grande, L; Sánchez, J; Moreno, L; Perez-Elías, MJ; Antela, A; Moreno, J; del Campo, S; Moreno, S

Published Date

  • December 2004

Published In

Volume / Issue

  • 9 / 6

Start / End Page

  • 1027 - 1030

PubMed ID

  • 15651761

Pubmed Central ID

  • 15651761

Electronic International Standard Serial Number (EISSN)

  • 2040-2058

International Standard Serial Number (ISSN)

  • 1359-6535

Language

  • eng