title: Liver Stiffness Decreases Rapidly in Response to Successful Hepatitis C Treatment and Then Plateaus.
abstract: OBJECTIVE
  To investigate the impact of a sustained virological response (SVR) to hepatitis C virus (HCV) treatment on liver stiffness (LS).
  
  
  METHODS
  LS, measured by transient elastography (FibroScan), demographic and laboratory data of patients treated with interferon (IFN)-containing or IFN-free regimens who had an SVR24 (undetectable HCV viral load 24 weeks after the end of treatment) were analyzed using two-tailed paired t-tests, Mann-Whitney Wilcoxon Signed-rank tests and linear regression. Two time intervals were investigated: pre-treatment to SVR24 and SVR24 to the end of follow-up. LS scores ≥ 12.5 kPa indicated LS-defined cirrhosis. A p-value below 0.05 was considered statistically significant.
  
  
  RESULTS
  The median age of the patients (n = 100) was 60 years [IQR (interquartile range) 54-64); 72% were male; 60% were Caucasian; and 42% had cirrhosis pre-treatment according to the FibroScan measurement. The median LS score dropped from 10.40 kPa (IQR: 7.25-18.60) pre-treatment to 7.60 kPa (IQR: 5.60-12.38) at SVR24, p <0.01. Among the 42 patients with LS-defined cirrhosis pre-treatment, 25 (60%) of patients still had LS scores ≥ 12.5 kPa at SVR24, indicating the persistence of cirrhosis. The median change in LS was similar in patients receiving IFN-containing and IFN-free regimens: -1.95 kPa (IQR: -5.75 --0.38) versus -2.40 kPa (IQR: -7.70 --0.23), p = 0.74. Among 56 patients with a post-SVR24 LS measurement, the LS score changed by an additional -0.90 kPa (IQR: -2.98-0.5) during a median follow-up time of 1.17 (IQR: 0.88-1.63) years, which was not a statistically significant decrease (p = 0.99).
  
  
  CONCLUSIONS
  LS decreased from pre-treatment to SVR24, but did not decrease significantly during additional follow-up. Earlier treatment may be needed to reduce the burden of liver disease.
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: Sweta
authors.identifier: http://orcid.org/0000-0003-2123-1951
authors.initials: S
authors.lastname: Chekuri
authors.affiliation: Department of Medical Education, Icahn School of Medicine at the Mount Sinai Medical Center, New York, NY, United States of America.
authors.forename: Jillian
authors.initials: J
authors.lastname: Nickerson
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: Kian
authors.initials: K
authors.lastname: Bichoupan
authors.affiliation: Department of Medical Education, Icahn School of Medicine at the Mount Sinai Medical Center, New York, NY, United States of America.
authors.forename: Roberta
authors.initials: R
authors.lastname: Sefcik
authors.affiliation: Department of Medical Education, Icahn School of Medicine at the Mount Sinai Medical Center, New York, NY, United States of America.
authors.forename: Kamini
authors.initials: K
authors.lastname: Doobay
authors.affiliation: Department of Medical Education, Icahn School of Medicine at the Mount Sinai Medical Center, New York, NY, United States of America.
authors.forename: Sanders
authors.initials: S
authors.lastname: Chang
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: David
authors.initials: D
authors.lastname: DelBello
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: Alyson
authors.initials: A
authors.lastname: Harty
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Dieterich
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: Ponni V
authors.initials: PV
authors.lastname: Perumalswami
authors.affiliation: Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Branch
mesh_terms: D001696:Biomechanical Phenomena; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D016014:Linear Models; D008099:Liver / Q000473:pathology / Q000503:physiopathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological
chemical_list: D007372:Interferons