title: The relationship between liver stiffness measurement and outcome in patients with chronic hepatitis C and cirrhosis: a retrospective longitudinal hospital study.
abstract: BACKGROUND
  There is a relationship between liver stiffness measurement (LSM) and outcome of HCV patients.
  
  
  OBJECTIVE
  To evaluate the performance of LSM to predict outcome of HCV patients at risk of liver-related complication.
  
  
  METHODS
  We established a retrospective longitudinal cohort of 341 HCV patients with unequivocal cirrhosis. All underwent LSM and were followed from September 2006 to July 2015. Outcome measure was a composite end-point of end-stage liver disease (ESLD) and/or hepatocellular carcinoma (HCC). Cox models and areas under receiver operating characteristic (AUROC) curves were used to evaluate independent risk factors of outcome.
  
  
  RESULTS
  Overall, LSM was below the 12.5 kPa threshold in 129 (37.8%) patients, including three-fourth and one-third of patients with or without a sustained virological response respectively. Liver disease progressed in 136 (39.9%) patients after a median observational period of 23.5 months. Older age, male gender, alcohol use disorders, metabolic syndrome and LSM were independent risk factors of liver disease progression. Age, alcohol use disorders and LSM were independently associated with ESLD. Age, gender and metabolic syndrome, but not LSM, were associated with HCC. The AUROC curves for disease progression, ESLD and HCC were 0.67, 0.70 and 0.58 respectively. Patients with a liver stiffness >12.5 kPa were at the highest risk of liver disease progression; below 12.5 kPa, liver stiffness was not discriminant.
  
  
  CONCLUSIONS
  Liver stiffness measurement is not a surrogate of disease progression of HCV patients with cirrhosis. HCV patients with cirrhosis should undergo the recommended follow-up, regardless of liver stiffness measurement.
authors.affiliation: Université Paris Descartes, Paris, France.|Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.|Institut National de la Santé et de la Recherche Médicale Unité 1223, Institut Pasteur, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Sultanik
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Kramer
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Soudan
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Medical Information Service, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bouam
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Virology Service, Paris, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Meritet
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.|Institut National de la Santé et de la Recherche Médicale Unité 1223, Institut Pasteur, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Vallet-Pichard
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.|Institut National de la Santé et de la Recherche Médicale Unité 1223, Institut Pasteur, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Fontaine
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Bousquet
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Boueyre
authors.affiliation: Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Corouge
authors.affiliation: Université Paris Descartes, Paris, France.|Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.|Institut National de la Santé et de la Recherche Médicale Unité 1223, Institut Pasteur, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Sogni
authors.affiliation: Université Paris Descartes, Paris, France.|Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.|Institut National de la Santé et de la Recherche Médicale Unité 1223, Institut Pasteur, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Pol
authors.affiliation: Université Paris Descartes, Paris, France.|Assistance Publique - Hôpitaux de Paris (AP-HP), Groupe Hospitalier Cochin Port Royal, Paris, France.|Hepatology Service, Paris, France.|Institut National de la Santé et de la Recherche Médicale Unité 1223, Institut Pasteur, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Mallet
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D054459:Elasticity Imaging Techniques / Q000639:trends*; D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome