Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis‐4 score and aspartate aminotransferase‐platelet ratio index

Bachofner, Jacqueline; Valli, Piero V.; Kröger, Arne; Bergamin, Irina; Künzler, Patrizia; Baserga, Adriana; Braun, Dominique L; Seifert, Burkhardt; Moncsek, Anja; Fehr, Jan; Semela, David; Magenta, Lorenzo; Müllhaupt, Beat; Beretta‐Piccoli, Benedetta Terziroli; Mertens, Joachim C.

doi:10.1111/liv.13256

Cited by 237 publications

(220 citation statements)

References 26 publications

(32 reference statements)

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“…Also in this study we found significant regression in fibroscan value detected in all patients at the end of treatment and 6 months post-treatment, also the study done by Jacqueline et al, 2017 showed that patients with SVR after DAA therapy showed marked improvement in median transient elastography values from 12.65 kPa to 8.55kPa (8).…”

Section: Discussionsupporting

confidence: 61%

“…(7) And this was proved by significant regression of the parameters of transient elastography after SVR. (8) Fibroscan is used to determine the degree of liver fibrosis but, its role in assessment of PH and prediction of varices is controversial. (9) Also, Color Doppler ultrasound can be used noninvasively to assess the degree of inflammation and fibrosis in patients with chronic viral hepatitis.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Portal Hypertension Doppler Parameters after Hepatitis C Virus Eradication in Patients with Definite Fibrosis

Mahmoud¹,

Osman²,

Abdelrazek³

et al. 2017

Int. J. Curr. Res. Med. Sci

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Backgrounds and aims: Eradication of hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs)nowadays is almost always successful and sustained virological response (SVR) occurs in more than 90% of cases and this prevent more fibrosis and preclude the progression of portal hypertension (PH). We aimed to evaluate the portal hypertensive Doppler parameters as a marker of PH after treatment of HCV with DAAs. Methods: 200 patients with post chronic HCV infection and definite liver fibrosis ≥F2 were included. All patients underwent laboratory investigations (liver function tests, complete blood count and serum creatinine), abdominal ultrasonography (US), portal Doppler US, fibroscan and upper endoscopy examinations. All patients were treated with DAAs for 12 weeks and then reevaluated for laboratory tests, fibroscan and hepatic Doppler US at the end of treatment and 6 months later. Comparison between those investigations at baseline, end of treatment and 6 months after treatment was analyzed. Results: 120 females (60%) and 80 males (40%) were included. Their mean ages were 45.0±12.9; and mean ChildPugh score was 6.35±1.2. The mean baseline value for fibroscan was 16.17±3.9 kPa; thirteen of them (6.5%) were F2, 63 (31.5%) were F3 and 124 (62%) were F4. Liver function tests including serum bilirubin and albumin, prothrombin time and concentration (PT& PC), liver enzymes (ALT and AST) were improved with variable significant values 6 months after treatment. Also Hemoglobin and platelet count were significantly increased both at the end of treatment and 6 months later. Fibroscan values decreased significantly both at the end of treatment and 6 months later (P value= 0.001 and 0.000 respectively). Portal hypertensive parameters including portal vein velocity (PVV), portal volume flow (PVF), portal hypertensive index (PHI), congestion index of portal vein (CI) and Spleno-portal index (SPI) were improved significantly both at the end of treatment and 6 months later (P value= 0.001 and 0.000 respectively, for all parameters). Patients without esophageal varices (OVs) showed more significant degrees of improvement in both fibroscan and portal hypertensive parameters than those with varices. Conclusions: Doppler portal hypertensive parameters, as a marker of portal hypertension, were improved in parallel with the improvement in fibroscan values after viral clearance and its improvement in early conditions in the current study mandate urgent treatment to avoid possible complications.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Evaluation of Portal Hypertension Doppler Parameters after Hepatitis C Virus Eradication in Patients with Definite Fibrosis

Mahmoud¹,

Osman²,

Abdelrazek³

et al. 2017

Int. J. Curr. Res. Med. Sci

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“…Also median FIB-4 and APRI values significantly decreased. In conclusion the authors asked themselves if the rapid decrease of TE measurements, which was in concordance with the significant decrease in the biologic fibrosis scores was linked entirely to a decrease of fibrosis, or it was also due to the resolution of the inflammation following SVR [8].…”

Section: Resultsmentioning

confidence: 99%

“…A German study evaluated a cohort of 392 HCV patients treated with IFT [8]. Transient elastography values, APRI score and FIB-4 were recorded prior to IFT and at 18 months after therapy.…”

Section: Resultsmentioning

confidence: 99%

“…One of the most important questions that arise is what happens with liver fibrosis following a sustained virologic response (SVR). Many published studies have shown a partial reversibility of fibrosis during treatment or after SVR in HCV or HBV chronic infection [2][3][4][5][6][7][8]. Post treatment evaluation of liver fibrosis was performed only by liver biopsy for a long time.…”

Section: Introductionmentioning

confidence: 99%

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Dynamics of Liver Stiffness Values by means of Transient Elastography in Patients with HCV Liver Cirrhosis undergoing Interferon Free Treatment

Sporea

Lupușoru

Mare

et al. 2017

JGLD

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Background & Aims: Liver stiffness (LS) measurement by Transient Elastography (TE) has been widely accepted as a tool for fibrosis assessment. The aim of this study was to assess LS dynamics in a group of patients with HCV liver cirrhosis after interferon free treatment (IFT).Methods: This two-center clinical trial included 225 patients with compensated HCV cirrhosis (all genotype 1b), who received IFT for 12 weeks. All patients were evaluated by means of TE at the beginning and at the end of treatment (EOT), and a subgroup (170 patients) also 12 weeks after EOT; all of them had sustained viral response (SVR). Reliable LS measurements (LSM) were defined as a median value of 10 valid LSM, with IQR <30% and SR ≥60%. Both M and XL probes were used. For diagnosing cirrhosis we used a cut-off value of 12kPa as proposed by the Tsochatzis meta-analysis. We considered a decrease or increase of more than 10% in LSM as being significant.Results: Out of 225 subjects, reliable measurements were obtained in 93.7%, so that the final analysis included 211 patients. The mean LS values decreased significantly after IFT: 26.4±11.7 vs. 23.5±13.3 kPa (p=0.01). Most patients, 59.2% (125/211) presented more than 10% decrease in LS values, 24.1% (51/211) had stable LS values, while in 16.4% (35/211) cases, the LS values increased. In the subgroup of 170 patients with LSM also performed 12 weeks after EOT (SVR), the mean LS values were significantly lower as compared to baseline: 21.3±11 kPa vs. 27.4±11.9 kPa (p<0.0001) and also as compared to EOT: 21.3±11 kPa vs. 23.7±13.3 kPa (p<0.0001).Conclusion: In our patients with HCV liver cirrhosis, the mean LS values evaluated by TE significantly decreased after antiviral treatment at EOT and also 12 weeks after EOT as compared to baseline. Overall, about 60% of patients had LS values at EOT lower than at baseline, while 12 weeks after EOT about 75% of patients had LS values lower than at baseline. –.Abbreviations: APRI: aspartate aminotransferase platelet ratio index; BMI: body mass index; DAA: direct acting agents; EOT: end of treatment; FIB-4: fibrosis 4; HBV: hepatitis B virus; HCV: hepatitis C virus; IFT: interferon free treatment; IQR: interquartile range; LS: liver stiffness; LSM: liver stiffness measurements; SR: success rate; SVR: sustained viral response; TE: Transient Elastography.

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All Patients With Advanced Fibrosis Should Continue to Be Screened for Hepatocellular Carcinoma After Sustained Virological Response of Hepatitis C Virus

Khan

Velpari

Koppe

2018

Clinical Liver Disease

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Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis‐4 score and aspartate aminotransferase‐platelet ratio index

Cited by 237 publications

References 26 publications

Evaluation of Portal Hypertension Doppler Parameters after Hepatitis C Virus Eradication in Patients with Definite Fibrosis

Evaluation of Portal Hypertension Doppler Parameters after Hepatitis C Virus Eradication in Patients with Definite Fibrosis

Dynamics of Liver Stiffness Values by means of Transient Elastography in Patients with HCV Liver Cirrhosis undergoing Interferon Free Treatment

All Patients With Advanced Fibrosis Should Continue to Be Screened for Hepatocellular Carcinoma After Sustained Virological Response of Hepatitis C Virus

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