title: Hepatic vein transit times of a microbubble agent in assessing response to antiviral treatment in patients with chronic hepatitis C.
abstract: Microbubble measurement of hepatic vein transit times (HVTT) may have the potential to assess severity of hepatitis C virus (HCV)-related liver disease, where there is a shorter HVTT with more severe disease. We investigated the utility of this test as a marker of response to antiviral treatment. Thirty-seven patients with biopsy-proven HCV-related disease undergoing antiviral treatment were studied. All had baseline scans and then repeat scans 6 months after the end of treatment. HVTT using Levovist were obtained from the right and middle hepatic veins, and the shorter time was used for analysis. The aspartate aminotransferase to platelet ratio index (APRI) scores were calculated retrospectively. There were seven patients with mild hepatitis, 23 with moderate/severe hepatitis and seven with cirrhosis. The mean baseline HVTT in responders ± SE increased from 27.3 ± 2.29 s to 33.5 ± 2.8 s posttreatment (P = 0.01). In the 10 nonresponders, the HVTT remained the same; 43.3 ± 9 s baseline compared to 44 ± 7.8 s posttreatment (P = 0.84). This trend was also seen with the APRI score where in responders, the mean score decreased from 1.1 ± 0.2 to 0.74 ± 1 (P = 0.03) and in nonresponders, the score remained unchanged; 0.88 ± 0.2 compared to 0.84 ± 0.2 (P = 0.31). HVTT measurement lengthened, while APRI scores decreased in patients who responded to antiviral treatment while both remained the same, shortened (HVTT) or increased (APRI), respectively, in patients who were nonresponders. These results are encouraging and indicate that these tests could be potentially used as markers of response to treatment and could obviate the need for serial biopsies in antiviral future treatment studies.
authors.affiliation: Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital, London, UK. a.lim@imperial.ac.uk
authors.forename: A K P
authors.initials: AK
authors.lastname: Lim
authors.forename: N
authors.initials: N
authors.lastname: Patel
authors.forename: R J
authors.initials: RJ
authors.lastname: Eckersley
authors.forename: J F L
authors.initials: JF
authors.lastname: Cobbold
authors.forename: M M E
authors.initials: MM
authors.lastname: Crossey
authors.forename: D O
authors.initials: DO
authors.lastname: Cosgrove
authors.forename: R D
authors.initials: RD
authors.lastname: Goldin
authors.forename: H C
authors.initials: HC
authors.lastname: Thomas
authors.forename: S D
authors.initials: SD
authors.lastname: Taylor-Robinson
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000493:pharmacokinetics*; D001219:Aspartate Aminotransferases / Q000097:blood; D003287:Contrast Media / Q000493:pharmacokinetics*; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010976:Platelet Count; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D003287:Contrast Media; D001219:Aspartate Aminotransferases