title: Liver stiffness diminishes with antiviral response in chronic hepatitis C.
abstract: BACKGROUND
  Transient elastography measures liver stiffness, which correlates with the hepatic fibrosis stage and has excellent accuracy for the diagnosis of cirrhosis in patients with chronic hepatitis C.
  
  
  OBJECTIVE
  To assess prospectively the kinetics of liver stiffness in treated patients with chronic hepatitis C and compare them with the viral kinetics on treatment and with the final outcome of therapy.
  
  
  METHODS
  91 patients with chronic hepatitis C with significant fibrosis (>7.0kPa) at baseline were included. They received therapy with pegylated interferon-α and ribavirin. The kinetics of liver stiffness were characterized during therapy and thereafter by means of Fibroscan, and compared with the virological responses at weeks 4, 12, 24, end of treatment and 12 and 24weeks after.
  
  
  RESULTS
  A significant liver stiffness decrease was observed during therapy, which continued after treatment only in patients who achieved a sustained virological response. In this group, the median intra-patient decrease relative to baseline at the end of follow-up was -3.4kPa, vs-1.8kPa in the patients who did not achieve an SVR. Similar dynamics were observed in cirrhotic and non-cirrhotic patients. In multivariate analysis, only the SVR was associated with long-term improvement of liver stiffness (odds ratio: 3.10; 95% confidence interval: 1.20-8.02, P=0.019).
  
  
  CONCLUSIONS
  In patients with advanced fibrosis at the start of therapy, liver stiffness is significantly reduced during treatment, but improvement continues off treatment only in patients who achieve a sustained virological response. Liver stiffness assessment earlier than 6months after the end of therapy does not appear to be clinically meaningful.
authors.affiliation: Department of Hepatology and Gastroenterology, Hôpital Henri Mondor, Université Paris-Est, Créteil, France. INSERM U955, Créteil, France.
authors.forename: C
authors.initials: C
authors.lastname: Hézode
authors.forename: L
authors.initials: L
authors.lastname: Castéra
authors.forename: F
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: M
authors.initials: M
authors.lastname: Bouvier-Alias
authors.forename: I
authors.initials: I
authors.lastname: Rosa
authors.forename: D
authors.initials: D
authors.lastname: Roulot
authors.forename: V
authors.initials: V
authors.lastname: Leroy
authors.forename: A
authors.initials: A
authors.lastname: Mallat
authors.forename: J-M
authors.initials: JM
authors.lastname: Pawlotsky
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D054459:Elasticity Imaging Techniques; D005260:Female; D005602:France; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011446:Prospective Studies; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a