Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis
Background/Aims Cirrhotic patients with liver stiffness measurement (LSM) <20 kPa and platelet count ≥150×109/L (Baveno VI criteria), otherwise spleen stiffness measurement (SSM) ≤40 kPa (Baveno VI-SSM criteria) can avoid endoscopy screening; however, no prospective data for their hepatic outcome...
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Korean Association for the Study of the Liver
2025-07-01
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| Series: | Clinical and Molecular Hepatology |
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| author | Haiyu Wang Weihao Liang Ling Zhou Jiankang Song Biao Wen Qiaoping Wu Yuanjian Zhang Xiaofeng Zhang Haoran Ke Yujun Tang Fuyuan Zhou Youfu Zhu Weiqun Wen Zhihua Liu Yali Ji Qintao Lai Qinjun He Wenfan Luo Tingting Qi Miaoxia Liu Xiaoqin Lan Yongpeng Chen Ranran Xi Junting Wan Lin Dai Yuan Li Jinjun Chen |
| author_facet | Haiyu Wang Weihao Liang Ling Zhou Jiankang Song Biao Wen Qiaoping Wu Yuanjian Zhang Xiaofeng Zhang Haoran Ke Yujun Tang Fuyuan Zhou Youfu Zhu Weiqun Wen Zhihua Liu Yali Ji Qintao Lai Qinjun He Wenfan Luo Tingting Qi Miaoxia Liu Xiaoqin Lan Yongpeng Chen Ranran Xi Junting Wan Lin Dai Yuan Li Jinjun Chen |
| author_sort | Haiyu Wang |
| collection | DOAJ |
| description | Background/Aims Cirrhotic patients with liver stiffness measurement (LSM) <20 kPa and platelet count ≥150×109/L (Baveno VI criteria), otherwise spleen stiffness measurement (SSM) ≤40 kPa (Baveno VI-SSM criteria) can avoid endoscopy screening; however, no prospective data for their hepatic outcomes. Methods Compensated cirrhosis with HBV were prospectively enrolled from April 2019 to April 2022 and followed until July 2023. All patients underwent LSM, SSM and esophagogastroduodenoscopy assessment. Results Among 1,224 patients enrolled with median follow-up of 30 months (interquartile range, 21–42), the incidence of decompensation was greater in 560 patients with unfavored Baveno VI criteria (0.5 vs. 20.4 per 1,000 person-years, P=0.0004) than that in 664 patients with favored Baveno VI-SSM criteria. The Baveno VI-SSM model identified more patients (54.2%) as low-risk for decompensation than Baveno VII-SSM model (single cutoff) (48.4%, P=0.004) and than Baveno VI criteria (34.6%, p<0.0001) did. Patients with high-risk varices diagnosed via endoscopy following Baveno VI-SSM model assessment had greater probability of decompensation compared to those identified by the Baveno VII-SSM model (single cutoff) (42.8 vs. 21.1 per 1,000 person-years, P=0.0088). Additionally, among the 493 patients who underwent endoscopic re-assessment, 242 patients with favored Baveno VI-SSM criteria had much lower incidence of EV progression (2.6 vs. 99.5 per 1,000 person-years, P=0.0004) and lower risk of decompensation compared to 140 patients with unfavored Baveno VI-SSM model (0 vs. 34.2 per 1,000 person-years, P=0.0256). Conclusions Baveno VI-SSM model could identify HBV-related cirrhosis patients at low risk of decompensation, which was greatly improved upon Baveno VI-SSM reassessment. |
| format | Article |
| id | doaj-art-987d3bfd18b441db932af41d2026b21b |
| institution | DOAJ |
| issn | 2287-2728 2287-285X |
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| publishDate | 2025-07-01 |
| publisher | Korean Association for the Study of the Liver |
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| series | Clinical and Molecular Hepatology |
| spelling | doaj-art-987d3bfd18b441db932af41d2026b21b2025-08-20T02:40:14ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2025-07-0131386688010.3350/cmh.2024.06092160Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosisHaiyu Wang0Weihao Liang1Ling Zhou2Jiankang Song3Biao Wen4Qiaoping Wu5Yuanjian Zhang6Xiaofeng Zhang7Haoran Ke8Yujun Tang9Fuyuan Zhou10Youfu Zhu11Weiqun Wen12Zhihua Liu13Yali Ji14Qintao Lai15Qinjun He16Wenfan Luo17Tingting Qi18Miaoxia Liu19Xiaoqin Lan20Yongpeng Chen21Ranran Xi22Junting Wan23Lin Dai24Yuan Li25Jinjun Chen26 Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, China Department of Infectious Diseases, Nanfang Hospital, Southern Medical University; State Key Laboratory of Organ Failure Research; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology; Guangzhou, ChinaBackground/Aims Cirrhotic patients with liver stiffness measurement (LSM) <20 kPa and platelet count ≥150×109/L (Baveno VI criteria), otherwise spleen stiffness measurement (SSM) ≤40 kPa (Baveno VI-SSM criteria) can avoid endoscopy screening; however, no prospective data for their hepatic outcomes. Methods Compensated cirrhosis with HBV were prospectively enrolled from April 2019 to April 2022 and followed until July 2023. All patients underwent LSM, SSM and esophagogastroduodenoscopy assessment. Results Among 1,224 patients enrolled with median follow-up of 30 months (interquartile range, 21–42), the incidence of decompensation was greater in 560 patients with unfavored Baveno VI criteria (0.5 vs. 20.4 per 1,000 person-years, P=0.0004) than that in 664 patients with favored Baveno VI-SSM criteria. The Baveno VI-SSM model identified more patients (54.2%) as low-risk for decompensation than Baveno VII-SSM model (single cutoff) (48.4%, P=0.004) and than Baveno VI criteria (34.6%, p<0.0001) did. Patients with high-risk varices diagnosed via endoscopy following Baveno VI-SSM model assessment had greater probability of decompensation compared to those identified by the Baveno VII-SSM model (single cutoff) (42.8 vs. 21.1 per 1,000 person-years, P=0.0088). Additionally, among the 493 patients who underwent endoscopic re-assessment, 242 patients with favored Baveno VI-SSM criteria had much lower incidence of EV progression (2.6 vs. 99.5 per 1,000 person-years, P=0.0004) and lower risk of decompensation compared to 140 patients with unfavored Baveno VI-SSM model (0 vs. 34.2 per 1,000 person-years, P=0.0256). Conclusions Baveno VI-SSM model could identify HBV-related cirrhosis patients at low risk of decompensation, which was greatly improved upon Baveno VI-SSM reassessment.http://e-cmh.org/upload/pdf/cmh-2024-0609.pdfliver cirrhosisbaveno vi-ssmportal hypertensiondecompensationchronic hepatitis b |
| spellingShingle | Haiyu Wang Weihao Liang Ling Zhou Jiankang Song Biao Wen Qiaoping Wu Yuanjian Zhang Xiaofeng Zhang Haoran Ke Yujun Tang Fuyuan Zhou Youfu Zhu Weiqun Wen Zhihua Liu Yali Ji Qintao Lai Qinjun He Wenfan Luo Tingting Qi Miaoxia Liu Xiaoqin Lan Yongpeng Chen Ranran Xi Junting Wan Lin Dai Yuan Li Jinjun Chen Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis Clinical and Molecular Hepatology liver cirrhosis baveno vi-ssm portal hypertension decompensation chronic hepatitis b |
| title | Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis |
| title_full | Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis |
| title_fullStr | Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis |
| title_full_unstemmed | Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis |
| title_short | Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis |
| title_sort | baveno vi ssm stratifies the risk of portal hypertension related events in patients with hbv related cirrhosis |
| topic | liver cirrhosis baveno vi-ssm portal hypertension decompensation chronic hepatitis b |
| url | http://e-cmh.org/upload/pdf/cmh-2024-0609.pdf |
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