Longitudinal assessment of liver stiffness in patients undergoing antiviral treatment for hepatitis C |
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Authors: | Cristina Stasi Umberto Arena Anna Linda Zignego Giampaolo Corti Monica Monti Elisa Triboli Elena Pellegrini Sara Renzo Luisa Leoncini Fabio Marra Giacomo Laffi Stefano Milani Massimo Pinzani |
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Institution: | 1. Department of Internal Medicine, University of Florence, Florence, Italy;2. Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy;3. Department of Clinical Pathophysiology, University of Florence, Florence, Italy;4. UCL Institute for Liver and Digestive Health, Royal Free Hospital London, London, United Kingdom |
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Abstract: | BackgroundLiver stiffness has been suggested as a parameter of fibrosis progression/regression in hepatitis C virus (HCV) patients.AimTo evaluate stiffness before and after peginterferon–ribavirin treatment.MethodsStiffness was prospectively measured in 74 HCV patients, 32 genotypes 1/4 (43.25%) and 42 genotypes 2/3 (56.75%), before, at end of treatment, and after 3 years of follow-up (49 patients). On the same study day, 21 patients underwent liver biopsy.ResultsIn 55 patients with sustained virological response (74.32%), liver stiffness decreased significantly at end of therapy (6.8 ± 4.9 kPa) vs. baseline (9.5 ± 6.9 kPa, p = 0.04). The decrease vs. baseline was maintained in 30 sustained virological response patients after 3 years follow-up (6.8 ± 4.6 kPa vs. 10.8 ± 8.5 kPa, p = 0.0141). No difference was found at end of treatment vs. baseline (10.1 ± 4.7 kPa vs. 9.7 ± 4.2 kPa, p = 0.825) and after 3 years of follow-up vs. baseline (10.2 ± 3.4 kPa vs. 9.7 ± 4.2 kPa, p = 0.765) in null responders. Similar results were found in relapsers at end of treatment vs. baseline (13.7 ± 7.7 kPa vs. 15.2 ± 8.2 kPa, p = 0.74), and after 3 years of follow-up vs. baseline (16.9 ± 10.0 kPa vs. 15.2 ± 8.2 kPa, p = 0.734). Pre-treatment stiffness >12 kPa was significantly associated with no SVR (p < 0.025), RR = 2.44 (95% C.I. 1.17–5.07).ConclusionLiver stiffness may be useful to assess long-term antiviral treatment response. |
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Keywords: | AR attributable risk CHC chronic hepatitis C CLD chronic liver diseases HCV hepatitis C virus IQR interquartile range NR null response RR relative risk SOC standard of care SVR sustained virologic response TE transient elastography |
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