Background: Evaluate the role of liver stiffness measurement (LSM) by transient elastography (TE) as a risk factor for hepatocellular carcinoma (HCC) occurrence in a prospective cohort of Brazilian hepatitis C virus (HCV) patients with cirrhosis. Methods: A cohort of 99 consecutive HCV patients was included between 2011 and 2016 with baseline LSM ≥12 kilopascals (kPa). Baseline variables were evaluated and HCC occurrence was documented. Kaplan-Meier methods with a log-rank test and the use of cox univariate and multivariate analysis assessed the association between variables and clinical results. Results: The mean age was 57.8±10.6 years. In a follow-up over a mean of 3.3 years, 20 (20.2%) patients developed HCC. In univariate logistic regression analysis, variables associated with HCC occurrence were: lower platelet count (P=0.0446), higher serum alpha-fetoprotein (P=0.0041) and bilirubin (P=0.0008) values, higher Model for End-Stage Liver Disease (MELD) score (P=0.0068) and higher LSM (P=0.0354). LSM evaluated by TE was independently associated with HCC development, and the best cut-off value for higher HCC risk was >21.1 kPa (HR: 5.548; 95%CI: 1.244-24.766; P=0.025). Conclusion: A high value of liver stiffness relates substantially to an increased risk for HCC occurrence in Brazilian patients with cirrhosis due to HCV.

Background and Aim The aim was to analyze the concordance of liver stiffness measurement (LSM) either by transient elastography (TE) or ARFI with liver biopsy in autoimmune hepatitis (AIH) patients with biochemical remission and to identify those with histological remission. Liver biopsy is still the golden standard for AIH diagnosis. However, it is an invasive procedure and these patients, most of the time, require many biopsies, so it would be valuable to search for noninvasive method that could select all these patients and keep under observation. Methods Thirty‐three patients with AIH were submitted for liver biopsy to evaluate histological remission after at least 18 months of normal aminotransferases. The efficiency of LSM and fibrosis stages was tested by a receiver operating characteristic curve analysis (AUROC). Results One patient (3%) was F0, 6 (18.2%) were F1, 8 (24.2%) were F2, 10 (30.3%) were F3, and 8 (24.2%) were F4, according to METAVIR. Thirteen of thirty‐three (39.4%) patients did not achieve histological remission. AUROC for F4 stage was 0.83 (IC: 0.76–0.99) for TE and 0.78 (IC: 0.65–0.95) for ARFI. Optimal LSM cutoff values were 12.3 kPa (Se = 87.5%, Sp = 88%) for TE and 1.65 m/s (Se = 87.5%, Sp = 76%) for ARFI. The tests were unable to differentiate patients with histological activity from those in histological remission (P < 0.05). Conclusion TE and ARFI accurately identify liver fibrosis by METAVIR score in AIH patients with biochemical remission. No cutoff value was detected to indicate whether the patient achieved histological remission.

Background: The identification and selection of patients at-risk for HCC is a recognized challenge in outpatient clinical practice. Limited data on risk factors and the impact of HCC on cirrhotic patients stratified by the elasticity imaging technique are still a potential promise. Aim: To evaluate the clinical contribution of liver stiffness measurement by transient elastography, as a risk factor for Hepatocellular Carcinoma (HCC) occurrence in a prospective cohort of (HCV) patients with cirrhosis. Method: A cohort of 99 consecutive HCV patients was included between 2011 and 2016 with baseline liver stiffness equal or above 12 kPa. We evaluated the patients with serum and mechanical liver tests. Kaplan-Meier method with the log-rank test and the use of Cox Univariate and multivariate analysis assessed the association between variables and clinical results. Results: The mean age was 57.8±10.6 years. In a follow-up over a mean of 3.3 years, 20 (20.2%) patients developed HCC, of which 65% were male and 40% had diabetes. The median time to diagnosis of HCC was 2.6 years. In univariate logistic regression analysis, variables associated with HCC occurrence were: lower platelet count (p=0.0446), higher serum alpha-fetoprotein (p=0.0041) and bilirubin (p=0.0008) values, higher MELD score (p=0.0068) and higher liver stiffness measurement (p=0.0354). High LSM evaluated by TE was independently associated with HCC development, and the best cut-off value for HCC risk was > 21.1kPa (HR: 4.7695; 95%CI: 1.0470-21.7274; p=0.0435). Conclusion: High value of liver stiffness relates substantially to the increased risk for HCC in selected patients with HCV cirrhosis.