Current Hepatology Reports

, Volume 18, Issue 2, pp 164–173 | Cite as

HVPG Measurements as a Surrogate of Clinical Events in Cirrhosis: Experience from Clinical Trials

  • Maria Gabriela Delgado
  • Jaume Bosch
Portal Hypertension (J Gonzalez-Abraldes and E Tsochatzis, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Portal Hypertension


Purpose of Review

Update current knowledge of the use of hepatic venous pressure gradient (HVPG) as a predictor of clinical events and of efficacy of therapy for portal hypertension.

Recent Findings

HVPG is a good predictor of clinical events. Decrease in HVPG during therapy is accompanied by a decreased incidence of complications from portal hypertension and improved survival.


HVPG measurements are a valuable tool in the management of portal hypertension in cirrhosis. In addition of detecting and grading the severity of portal hypertension, HVPG measurements provide robust prognostic information on the risk of complications, disease progression/regression, and survival. Changes in HVPG in response to therapy predict the effects on clinical outcomes, both during treatment with beta-blockers and when treating HCV-related cirrhosis with specific antivirals. This has led to suggest that HVPG can be used as a surrogate for clinical events when developing new therapies for portal hypertension. Limitations of this approach are discussed.


HVPG Portal hypertension Surrogate for clinical events Clinical trials New therapies 


Compliance with Ethical Standards

Conflict of Interest

Jaume Bosch reports personal fees from Conatus, personal fees from Gilead, grants and personal fees from Exallenz, personal fees from Actelion, personal fees from BioVie, grants from Brudy, other from BLB, and personal fees from Blade Therapeutics, outside the submitted work. Maria Gabriela Delgado declares no potential conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Maria Gabriela Delgado
    • 1
  • Jaume Bosch
    • 1
    • 2
  1. 1.Swiss Liver Center, Hepatology, University Clinic for Visceral Surgery and Medicine, Inselspital, Department of Biomedical ResearchUniversity of BernBerneSwitzerland
  2. 2.Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clinic, IDIBAPS, CiberehdUniversity of BarcelonaBarcelonaSpain

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