Durability of a sustained virological response, late clinical sequelae, and long-term changes in aspartate aminotransferase to the platelet ratio index after successful treatment with peginterferon/ribavirin for chronic hepatitis C

Papastergiou, Vasilios; Stampori, Maria; Lisgos, Phillipos; Pselas, Crisostomos; Prodromidou, Kleopatra; Karatapanis, Stylianos

doi:10.1097/meg.0b013e32835eb8bf

Cited by 14 publications

(8 citation statements)

References 21 publications

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“…We observed that patients who attained SVR exhibited significant improvements in each of these markers after treatment. These results were consistent with previous studies showing similar results for surrogate markers . These improvements remained significant even when patients were grouped according to their baseline Metavir score (F0–F1, F2 and F3–F4).…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies of patients successfully treated with interferon/ribavirin regimens have shown improvements in liver fibrosis after successful treatment using noninvasive blood biomarker tests . Here, we quantified how liver fibrosis improves in a large population ( N = 1208 patients) treated with antiviral regimens combining PR with the direct‐acting antiviral telaprevir.…”

Section: Discussionmentioning

confidence: 99%

“…Several large studies have been performed to examine the changes in liver fibrosis after interferon‐based treatment to determine the effect of HCV clearance on long‐term liver health. For patients who attained SVR, significant improvements from pretreatment stage (baseline) have been observed in APRI , Forns' Score , FibroTest , FibroMeter , SHASTA and transient elastography . Notably, fibrosis regression is assumed to occur slowly in patients achieving SVR as determined by FibroTest because this test correlated with biopsy results from both fibrosis progression and fibrosis regression .…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment with telaprevir‐based regimens for chronic hepatitis C results in significant improvements to serum markers of liver fibrosis

Haseltine

Penney

George

et al. 2015

Journal of Viral Hepatitis

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Patients infected with hepatitis C virus (HCV) have differing levels of liver health when they initiate treatment. We sought to quantify whether liver health improves following successful treatment with telaprevir-based antiviral regimens. We performed a retrospective analysis of data generated from one Phase 2 and two Phase 3 telaprevir clinical studies. 1208 patients treated with a telaprevir-based regimen were included in the analysis. Patients were grouped according to their baseline Metavir score (F0-F1, F2 and F3-F4) and whether or not they attained sustained virologic response (SVR). Scores from four biomarker tests, FibroTest, APRI, FIB-4 and Forns' Score, were monitored both before and after HCV treatment. All four of these tests differentiated the fibrosis stage as determined by Metavir score at baseline. Consistent with previous studies, patients who attained SVR exhibited significant improvements in scores from each of these tests after treatment. These improvements remained significant even when patients were grouped according to their baseline Metavir score. On average, the scores from different tests exhibited differential improvements following SVR. Improvements in APRI scores corresponded to complete fibrosis regression (i.e. a Metavir stage of F0-F1). In contrast, improvements in scores from Forns' Score, FIB-4 and FibroTest were more modest (i.e. fibrosis regression of less than a Metavir stage). Overall, these results demonstrated that attaining SVR with a telaprevir-based regimen led to significant improvements in liver health as determined by four biomarker tests. However, not all correlations observed between noninvasive markers and fibrosis stage at baseline hold after SVR is attained.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful treatment with telaprevir‐based regimens for chronic hepatitis C results in significant improvements to serum markers of liver fibrosis

Haseltine

Penney

George

et al. 2015

Journal of Viral Hepatitis

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“…[29][30][31] In our study AST, ALT, AFP also decreased, which is consistent to other studies. 18,32,33 Compared to baseline we found significant increase in albumin values (p˂0.01), which is also proved in the study by Deterding et al, albumin levels became normal in most of his patients. 30 We found significant decrease in bilirubin levels at end of treatment (p˂0.01), which is desirable in hepatic patients.…”

Section: Discussionsupporting

confidence: 89%

Therapeutic effects of Silybum marianum in the treatment of liver fibrosis and cirrhosis

Awan

Saeed²,

Usmanghani³

et al. 2019

Asian J Med Sci

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Background: Cirrhosis is the late, symptomatic stage of chronic liver disease which occurs when scar tissue (fibrosis) largely replaces healthy liver tissue, compromising the function of the organ and predisposing to liver failure and hepatocellular carcinoma. It is mainly caused by hepatitis B and C virus infections or prolonged excessive consumption of alcohol. Aims and Objective: To study the therapeutic effects of Silybum marianum on liver fibrosis and cirrhosis in patients with chronic hepatitis C virus infection with Child Pugh Stage A& B. Materials and Methods: In this study 119 patients were treated for 6 months with Silybum marianum, their Liver stiffness measurements were carried out through Fibroscan, which is a non-invasive technique to assess liver fibrosis. Liver Fibrosis Scores viz; Aspartate aminotransferase/platelet ratio index(APRI) and fibrosis index based on four factors(FIB-4) were also employed at baseline and end of treatment. Results: Pre-treatment Liver Stiffness Measurement (LSM) score was 22.54 kilopascals(kPa) and post treatment was 17.30 kPa, a statistically significant change of 5.24 kPa (P ˂ 0.01) was observed, the mean percent change was 23.24%, its impact was observed in all METAVIR stages. Of the 72 (60.5%) patients with LSM ≥ 12.5 kPa (cirrhosis) at baseline 23 (32%) proved to have no cirrhosis (≥ 1 decrease in fibrosis stage) at post treatment. Similarly, 19 patients moved to stage F0-F1, 28 patients in F2 and 23 in F3. Overall fibrosis stage was improved (≥ 1 decrease in fibrosis stage) in 46 (38.7%) of 119 patients after 6 months of treatment. Serum fibrosis scores APRI and FIB-4 significantly decreased in comparison to baseline values. APRI values drooped from 1.24 to 0.83. FIB-4 score changed from 3.90 to 2.10. Conclusion: Our result suggests significant improvement with Silybum marianum in the patients status of liver fibrosis and cirrhosis associated with hepatitis C related chronic liver disease. Silybum marianum shows therapeutic effect in real life setting on the entire aspect of disease, as evaluated with the fibroscan and serum fibrosis score.

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“…Although, SVR would be regarded as a sign of clinical cure and with reduced risk of HCC for patients with SVR, HCC might be unavoidable to all patients with CHC. A previous study results suggested that patients with CHC who had no evidence of virological relapse might still have the risk of HCC ( 27 ). The mechanism of HCC development in patients with SVR is elusive.…”

Section: Discussionmentioning

confidence: 99%

A Comprehensive Long-Term Prognosis of Chronic Hepatitis C Patients With Antiviral Therapy; A Meta-Analysis of Studies From 2008 to 2014

Wen

Zheng²,

Tan³

2015

Hepat Mon

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Context:Attaining a sustained virological response with antiviral therapy is a sign of clinical cure for chronic hepatitis C patients. The aim of this meta-analysis was to evaluate the long-term efficiency and outcome of antiviral therapy in patients with hepatitis C who attained a sustained virological response.Evidence Acquisition:A literature search was performed on published articles between January 2008 and February 2014. Patients with Hepatitis C who received interferon with or without ribavirin therapy were enrolled. Relative risks were estimated using either fixed or random effect models.Results:Patients who attained sustained virological response had a less risk (85%) for all-cause mortality and about 63% reduced risk of hepatocellular carcinoma incidence than those who did not achieve sustained virological response. Based on deeply analysis, the stage of liver fibrosis was a risk factor at baseline for the incidence of hepatocellular carcinoma.Conclusions:Sustained virological response can reduce all-cause mortality and the incidence of hepatocellular carcinoma of patients with hepatitis C. Advanced liver fibrosis is still a risk factor for the incidence of hepatocellular carcinoma, in spite of hepatitis C patients attained a sustained virological response.

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Durability of a sustained virological response, late clinical sequelae, and long-term changes in aspartate aminotransferase to the platelet ratio index after successful treatment with peginterferon/ribavirin for chronic hepatitis C

Cited by 14 publications

References 21 publications

Successful treatment with telaprevir‐based regimens for chronic hepatitis C results in significant improvements to serum markers of liver fibrosis

Successful treatment with telaprevir‐based regimens for chronic hepatitis C results in significant improvements to serum markers of liver fibrosis

Therapeutic effects of Silybum marianum in the treatment of liver fibrosis and cirrhosis

A Comprehensive Long-Term Prognosis of Chronic Hepatitis C Patients With Antiviral Therapy; A Meta-Analysis of Studies From 2008 to 2014

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