Longitudinal Liver Stiffness Assessment in Patients with Chronic Hepatitis C Undergoing Antiviral Therapy

Abstract

Background/AimsLiver stiffness (LS) measurement by means of transient elastography (TE) is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC).MethodsTE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC.Results323 treated (62.7%) and 192 untreated patients (37.3%) were assessed. LS experienced a significant decline in treated patients and remained stable in untreated patients at the end of study (P<0.0001). The decline was significant for patients with baseline LS ≥ 7.1 kPa (P<0.0001 and P 0.03, for LS ≥9.5 and ≥7.1 kPa vs lower values, respectively). Sustained virological responders and relapsers had a significant LS improvement whereas a trend was observed in nonresponders (mean percent change −16%, −10% and −2%, for SVR, RR and NR, respectively, P 0.03 for SVR vs NR). In multivariate analysis, high baseline LS (P<0.0001) and ALT levels, antiviral therapy and non-1 genotype were independent predictors of LS improvement.ConclusionsLS decreases during and after antiviral treatment in patients with CHC. The decrease is significant in sustained responders and relapsers (particularly in those with high baseline LS) and suggests an improvement in liver damage.

Ultrasound-Based Liver Stiffness Surveillance in Patients Treated for Chronic Hepatitis B or C

“…Apart from studies in which the cohorts were not stratified [32][33][34][35][36], non-SVR generally accounted for nonsignificant declines in liver stiffness. However, those who experienced a relapse in the non-SVR group still could exhibit significant declines in liver stiffness [30,37,38]. In the untreated groups recruited in various studies [29,30,37], nonsignificant declines in liver stiffness were observed throughout the timeframes.…”

“…However, those who experienced a relapse in the non-SVR group still could exhibit significant declines in liver stiffness [30,37,38]. In the untreated groups recruited in various studies [29,30,37], nonsignificant declines in liver stiffness were observed throughout the timeframes. However, SVR does not necessarily terminate the progression of disease course, particularly in patients with advanced cirrhosis at the baseline [4].…”

“…In addition to stratification by the SVR status, baseline liver stiffness values outweighed SVRs in the various regression analyses adopting various baseline and chronological host and viral covariates to explain the declines in liver stiffness [37][38][39][40] (Table 1). Declines in liver stiffness tended to be greater in patients with higher baseline liver stiffness values, reflecting the effects of biochemical response on liver stiffness over time [29].…”

Nem invazív fibrosisdiagnosztika hepatitis C-vírus-infekcióban: szerepe a kezelés indikációjában, követésében és a prognózis megítélésében

“…Martinez és mtsai kezelt és nem kezelt HCV-betegekben a májtömöttség (LS) szignifi káns csökkenését csak SVR esetén észlelték, a kezelés előtti magas GPT-és LS-érték, valamint a non-HCV1 genotípus független prediktora volt a regresszió-nak [26]. Poynard és mtsai Fibrotest és TE alkalmazásá-val ismételten vizsgáltak IFN-alapú kezelésben részesült, előrehaladott fi brosisú HCV-betegeket.…”

Task-based optimization of flip angle for fibrosis detection in T1-weighted MRI of liver

“…1,[3][4][5] HF is the hallmark of CLD. 2,[6][7][8] Monitoring for the presence of HF and staging (quantifying) the severity and progression over time are essential for the diagnosis and therapeutic management of CLD.…”