Non-neoplastic Portal Vein Thrombosis in HCV Cirrhosis Patients: Is it an Immuno-Inflammatory Disorder?

Ann Hepatol. 2017 Jul-Aug;16(4):574-583. doi: 10.5604/01.3001.0010.0296.


Background and aims: Portal vein thrombosis (PVT) is a critical complication in cirrhotic patients. We explored the role of the activated factor VII-antithrombin (FVIIa-AT) complex and enhanced monocytic tissue factor (TF) expression in the development and prediction of non-neoplastic PVT in cirrhotic patients.

Material and methods: A total of 30 HCV-cirrhosis patients were included in our study. They were compared to 35 cirrhotic patients without PVT, 15 non-cirrhotic patients with PVT, and 15 healthy controls. The plasma level of the FVIIa-AT complexes was analyzed by ELISA. MIF CD142, CD86, and HLA-DR on monocytes (CD14) were determined by flow cytometry.

Results: Compared with cirrhotic patients without PVT, cirrhotic patients with PVT had comparable plasma values of FVIIa, AT, and the FVIIa-AT complex. However, they had significantly lower values compared to non-cirrhotic patients with PVT and healthy controls. Cirrhotic patients with PVT had increased monocytic TF expression (MIF CD142) compared to non-PVT cirrhotic patients and healthy controls [86.5 (93.5) vs. 18 (32.0) and 11.0 (6.0), respectively; p < 0.001 for each]. However, cirrhosis PVT could not be distinguished from non-cirrhosis PVT. The area under the ROC curve of MIF CD142 was 0.759 (0.641- 0.876; p = 0.000) at an optimal cut-off value of 45, which yielded a sensitivity of 60% and a specificity of 77.1%, as well as a PPV and NPV of 69.2% for each.

Conclusion: Enhanced expression of monocytic TF may have a role in the development and prediction of non-neoplastic PVT in HCV-cirrhosis patients. Large multicenter studies are necessary to validate our results.

Keywords: Flow cytometry; Portal hypertension; Tissue factor.

MeSH terms

  • Adult
  • Antithrombins / analysis*
  • Area Under Curve
  • Biomarkers / blood
  • Blood Coagulation*
  • Case-Control Studies
  • Chi-Square Distribution
  • Factor VIIa / analysis*
  • Female
  • Hepatitis C / blood
  • Hepatitis C / complications*
  • Hepatitis C / diagnosis
  • Hepatitis C / immunology
  • Humans
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / immunology
  • Liver Cirrhosis / virology
  • Logistic Models
  • Male
  • Middle Aged
  • Multiprotein Complexes
  • Multivariate Analysis
  • Portal Vein* / diagnostic imaging
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Thromboplastin / analysis*
  • Venous Thrombosis / blood*
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / immunology
  • Venous Thrombosis / virology
  • Young Adult


  • Antithrombins
  • Biomarkers
  • Multiprotein Complexes
  • Thromboplastin
  • Factor VIIa