Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy.
OBJECTIVE
Liver 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).


METHODS
TE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC.


RESULTS
323 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.


CONCLUSIONS
LS 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.
Liver Unit, Hospital Clinic, IDIBAPS and CIBERehd, Barcelona, Spain.
Stella M
SM
Martinez
Juliette
J
Foucher
Jean-Marc
JM
Combis
Sophie
S
Métivier
Maurizia
M
Brunetto
Dominique
D
Capron
Marc
M
Bourlière
Jean-Pierre
JP
Bronowicki
Thong
T
Dao
Marianne
M
Maynard-Muet
Damien
D
Lucidarme
Wassil
W
Merrouche
Xavier
X
Forns
Victor
V
de Lédinghen
D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D054459:Elasticity Imaging Techniques; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000503:physiopathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents