Table 4.

Biomarkers of portal hypertension regression

Biomarker	Short description of study
Liver stiffness [39]	In a cohort of DAA-treated HCV patients, LS decrease (measured by TE) was associated with HVPG response. However, its accuracy was lower in patients with BL CSPH
Liver stiffness [37, 44]	In a cohort of DAA-treated patients, LS ≥ 21 kPa had a good performance in ruling in the persistence of CSPH after SVR (positive predictive value 82–91%); however, the lower cut-off of 13,6 kPa did not perform well in ruling out CSPH persistence
Liver stiffness [136]	In this small cohort of DAA-treated HCV patients, a cut-off value of < 12 kPa was accurate in ruling out CSPH after SVR
Liver stiffness and ELF score [40]	In a cohort of LT patients with HCV reinfection, LS was accurate in ruling in our out the persistence of CSPH (cut-off values < 11.3 and > 23 kPa resp) and the persistence of advanced fibrosis. Conversely, ELF showed good accuracy for CSPH, but was not associated with fibrosis regression
Liver stiffness and VITRO score [43]	In this cohort of DAA-treated HCV patients, TE and VITRO score performed well in ruling in/out CSPH after SVR. Their accuracy was especially high if used in a sequential manner, leaving 25% of patients unclassifiable
Spleen stiffness [137]	In this cohort of DAA-treated HCV patients, SS decreased significantly after SVR, more so in patients without BL CSPH. However, the presence and grade of PP was estimated based on LS, and no direct HVPG measurements were performed
Spleen stiffness [138]	This proof-of-concept study demonstrated that a decrease in spleen stiffness accurately predicts the hemodynamic response to primary prophylaxis with NSBB (Carvedilol) in patients with HREV. A prediction model containing SS had an AUC > 0.8 in both derivation and validation cohorts

ELF score Enhanced Liver Fibrosis score, which measures hyaluronic acid (HA), procollagen III amino-terminal peptide (PIIINP), and tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), HREV high-risk esophageal varices, LS liver stiffness, SS spleen stiffness, TE transient elastography, VITRO von Willebrand antigen to platelet ratio score