title: Longitudinal assessment of liver stiffness in patients undergoing antiviral treatment for hepatitis C.
abstract: BACKGROUND
  Liver stiffness has been suggested as a parameter of fibrosis progression/regression in hepatitis C virus (HCV) patients.
  
  
  OBJECTIVE
  To evaluate stiffness before and after peginterferon-ribavirin treatment.
  
  
  METHODS
  Stiffness 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.
  
  
  RESULTS
  In 55 patients with sustained virological response (74.32%), liver stiffness decreased significantly at end of therapy (6.8±4.9kPa) vs. baseline (9.5±6.9kPa, p=0.04). The decrease vs. baseline was maintained in 30 sustained virological response patients after 3 years follow-up (6.8±4.6kPa vs. 10.8±8.5kPa, p=0.0141). No difference was found at end of treatment vs. baseline (10.1±4.7kPa vs. 9.7±4.2kPa, p=0.825) and after 3 years of follow-up vs. baseline (10.2±3.4kPa vs. 9.7±4.2kPa, p=0.765) in null responders. Similar results were found in relapsers at end of treatment vs. baseline (13.7±7.7kPa vs. 15.2±8.2kPa, p=0.74), and after 3 years of follow-up vs. baseline (16.9±10.0kPa vs. 15.2±8.2kPa, p=0.734). Pre-treatment stiffness >12kPa was significantly associated with no SVR (p<0.025), RR=2.44 (95%C.I. 1.17-5.07).
  
  
  CONCLUSIONS
  Liver stiffness may be useful to assess long-term antiviral treatment response.
authors: Department of Internal Medicine, University of Florence, Florence, Italy. Electronic address: cristina.stasi@gmail.com.
authors: Cristina
authors: C
authors: Stasi
authors: Umberto
authors: U
authors: Arena
authors: Anna Linda
authors: AL
authors: Zignego
authors: Giampaolo
authors: G
authors: Corti
authors: Monica
authors: M
authors: Monti
authors: Elisa
authors: E
authors: Triboli
authors: Elena
authors: E
authors: Pellegrini
authors: Sara
authors: S
authors: Renzo
authors: Luisa
authors: L
authors: Leoncini
authors: Fabio
authors: F
authors: Marra
authors: Giacomo
authors: G
authors: Laffi
authors: Stefano
authors: S
authors: Milani
authors: Massimo
authors: M
authors: Pinzani
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D012367:RNA, Viral / Q000097:blood*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D019562:Viral Load; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C100416:peginterferon alfa-2a
keywords: AR; Antiviral treatment; CHC; CLD; Chronic hepatitis C; Fibrosis; HCV; IQR; Liver stiffness; NR; RR; SOC; SVR; Sustained virological response; TE; attributable risk; chronic hepatitis C; chronic liver diseases; hepatitis C virus; interquartile range; null response; relative risk; standard of care; sustained virologic response; transient elastography