title: Lower liver stiffness in patients with sustained virological response 4 years after treatment for chronic hepatitis C.
abstract: OBJECTIVE
  Transient elastography (TE) is a noninvasive and well validated method for measurement of liver stiffness. The aim of this study was to use TE to evaluate whether patients with sustained virological response (SVR) have lower liver stiffness than patients with non-SVR after treatment for chronic hepatitis C (CHC).
  
  
  METHODS
  Patients with CHC, who had undergone liver biopsy before treatment with pegylated interferon and ribavirin, were included from four clinical centres in Denmark. All patients were examined with TE and had a blood test taken for hepatitis C virus-virus detection and analysis of alanine aminotransferase, platelet counts and hyaluronic acid.
  
  
  RESULTS
  For 110 (92%) of the 120 patients included, it was possible to obtain a successful measurement of liver stiffness. Of these, 71 (64.5%) had achieved SVR. Median follow-up time was 47 months. Patients with pretreatment minimal fibrosis (F0/F1) in their liver biopsy had median liver stiffness of 5.3 kPa for SVR versus 6.1 kPa for non-SVR (P=0.56). Patients with pretreatment moderate fibrosis (F2/F3) had median liver stiffness of 5.4 kPa for SVR versus 9.4 kPa for non-SVR (P<0.001). Median liver stiffness for patients with pretreatment cirrhosis (F4) was 6.8 kPa for SVR versus 24 kPa for non-SVR (P<0.001).
  
  
  CONCLUSIONS
  Examination with TE 4 years after treatment shows that patients with CHC, who have achieved SVR, have significantly lower liver stiffness than patients with non-SVR. This indicates that histological liver outcome improves during the first year after the treatment for CHC.
authors.affiliation: Departments of Infectious Diseases, Hvidovre, Copenhagen University Hospital, Rigshospitalet, Denmark. ellensloth@dadlnet.dk
authors.forename: Ellen Sloth
authors.initials: ES
authors.lastname: Andersen
authors.forename: Belinda Klemmensen
authors.initials: BK
authors.lastname: Moessner
authors.forename: Peer Brehm
authors.initials: PB
authors.lastname: Christensen
authors.forename: Mette
authors.initials: M
authors.lastname: Kjær
authors.forename: Henrik
authors.initials: H
authors.lastname: Krarup
authors.forename: Søren
authors.initials: S
authors.lastname: Lillevang
authors.forename: Nina
authors.initials: N
authors.lastname: Weis
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003718:Denmark; D054459:Elasticity Imaging Techniques; D005260:Female; D016174:Hepacivirus / Q000187:drug effects* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D006820:Hyaluronic Acid; D000410:Alanine Transaminase; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a