Infectious Complications of Portal Hypertension.

Patients with cirrhosis and clinically significant portal hypertension are at high risk of developing bacterial infections (BIs) that are the most common trigger of acute decompensation and acute-on-chronic liver failure. Furthermore, after decompensation, the risk of developing BIs further increases in an ominous vicious circle. BIs may be subtle, and they should be ruled out in all patients at admission and in case of deterioration. Timely administration of adequate empirical antibiotics is the cornerstone of treatment. Herein, we reviewed current evidences about pathogenesis, clinical implications and management of BIs in patients with cirrhosis and portal hypertension.

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Disclosure PA held a patent with Biovie, received advisory board fees from Biovie, Biomarin, and GenFit and speaking fees from Grifols, Kedrion, and Bhering. SP received consulting fees from Plasma Protein Therapeutics Association and speaking fees from Grifols and Medscape. SI has nothing to disclose regarding the work under consideration for publication. No specific funding supported this study. Authors’ contribution: S. Incicco, P. Angeli, and S. Piano reviewed the literature and drafted the article.