Early fibrosis regression by shear wave elastography after successful direct-acting anti-HCV therapy

Kohla, Mohamed; Fayoumi, Ahmed El; Akl, Mohamed Farouk; Abdelkareem, Mervat; Elsakhawy, Mahmoud; Waheed, Sally; Abozeid, Mai

doi:10.1007/s10238-019-00597-0

Cited by 13 publications

(9 citation statements)

References 23 publications

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“…The results of our current study are in accordance with other studies in the field 20–23 . Moreover, we provide new and clinically important information up to three years post‐treatment for the management of patients with advanced liver disease and DAA‐induced SVR.…”

Section: Discussionsupporting

confidence: 90%

“…Regression of liver fibrosis was shown in patients treated with interferon up to 4 years after treatment, particularly in those who achieved SVR 18,19 . In recent years, studies analysing the effect of interferon‐free DAA regimens on fibrosis regression have demonstrated short‐term reduction in liver stiffness by different elastography techniques within 18 months post‐treatment 20–23 . However, studies with follow‐up intervals beyond several years are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study

Knop

Hoppe

Vermehren

et al. 2021

Journal of Viral Hepatitis

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Long‐term effects on cirrhosis and portal hypertension of direct antiviral agent (DAA)‐based eradication of hepatitis C virus (HCV) are still under debate. We analysed dynamics of liver and spleen elastography to assess potential regression of cirrhosis and portal hypertension 3 years post‐treatment. Fifty‐four patients with HCV‐associated cirrhosis and DAA‐induced SVR were included. Liver and spleen stiffness were measured at baseline (BL), end of treatment (EOT), 24 weeks after EOT (FU24) and 1, 2 and 3 (FU144) years post‐treatment by transient liver elastography (L‐TE) and point shear wave elastography (pSWE) using acoustic radiation force impulse (ARFI) of the liver (L‐ARFI) and spleen (S‐ARFI). Biochemical, virological and clinical data were also obtained. Liver stiffness assessed by L‐TE decreased between BL [median (range), 32.5(9.1–75) kPa] and EOT [21.3(6.7–73.5) kPa; p < .0001] and EOT and FU144 [16(4.1–75) kPa; p = .006]. L‐ARFI values improved between EOT [2.5(1.2–4.1) m/s] and FU144 [1.7(0.9–4.1) m/s; p = .001], while spleen stiffness remained unchanged. Overall, L‐TE improved in 38 of 54 (70.4%) patients at EOT and 29 of 38 (76.3%) declined further until FU144, whereas L‐ARFI values decreased in 30/54 (55.6%) patients at EOT and continued to decrease in 28/30 (93.3%) patients at FU144. Low bilirubin and high albumin levels at BL were associated with improved L‐ARFI values (p = .048) at EOT or regression of cirrhosis (<12.5 kPa) by L‐TE at FU144 (p = .005), respectively. Liver stiffness, but not spleen stiffness, continued to decline in a considerable proportion of patients with advanced liver disease after HCV eradication.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study

Knop

Hoppe

Vermehren

et al. 2021

Journal of Viral Hepatitis

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“…We observed hepatic stiffness decrease after DAA treatment, in agreement with previous studies that used single-frequency MRE at 60 Hz [44] and ultrasound elastography (USE) [19,[45][46][47][48][49][50]. These results suggest that reduction of the inflammation caused by DAA treatment is most probably the cause of the reduction in hepatic stiffness.…”

Section: Viscoelastic Daa Response In the Liversupporting

confidence: 91%

Tomoelastography for Longitudinal Monitoring of Viscoelasticity Changes in the Liver and in Renal Allografts after Direct-Acting Antiviral Treatment in 15 Kidney Transplant Recipients with Chronic HCV Infection

Garcia

Althoff

Dürr

et al. 2021

JCM

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Besides the liver, hepatitis C virus (HCV) infection also affects kidney allografts. The aim of this study was to longitudinally evaluate viscoelasticity changes in the liver and in kidney allografts in kidney transplant recipients (KTRs) with HCV infection after treatment with direct-acting antiviral agents (DAAs). Fifteen KTRs with HCV infection were treated with DAAs (daclatasvir and sofosbuvir) for 3 months and monitored at baseline, end of treatment (EOT), and 3 (FU1) and 12 (FU2) months after EOT. Shear-wave speed (SWS) and loss angle of the complex shear modulus (φ), reflecting stiffness and fluidity, respectively, were reconstructed from multifrequency magnetic resonance elastography data with tomoelastography post-processing. After virus elimination by DAAs, hepatic stiffness and fluidity decreased, while kidney allograft stiffness and fluidity increased compared with baseline (hepatic stiffness change at FU1: −0.14 m/s, p < 0.01, and at FU2: −0.11 m/s, p < 0.05; fluidity at FU1: −0.05 rad, p = 0.04 and unchanged at FU2: p = 0.20; kidney allograft stiffness change at FU1: +0.27 m/s, p = 0.01, and at FU2: +0.30 m/s, p < 0.01; fluidity at FU1 and FU2: +0.06 rad, p = 0.02). These results suggest the restoration of mechanically sensitive structures and functions in both organs. Tomoelastography can be used to monitor the therapeutic results of HCV treatment non-invasively on the basis of hepatic and renal viscoelastic parameters.

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“…Similar to VCTE, significant decrease in LSM by pSWE after AVT have been reported, yet, merely in few CHC patients. 40,45,46 It was considered that reduction of pSWE values indicates not only the improvement of fibrosis but also the resolution of liver inflammation, 40 as an early decline in liver stiffness after SVR was associated with the grade of histological inflammation at baseline. 47…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Elastography for Longitudinal Assessment of Liver Fibrosis after Antiviral Therapy: A Review

Wei

Song

2020

Journal of Clinical and Translational Hepatology

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Chronic hepatitis B or C viral infection is a common cause of liver cirrhosis and hepatocellular carcinoma. Fibrosis regression can be achieved after long-term antiviral therapy (AVT). Monitoring of dynamic changes in liver fibrosis after treatment is essential for establishing prognosis and formulation of a follow-up surveillance program. Routine surveillance of fibrosis after AVT by liver biopsy, the gold standard for fibrosis assessment, is hindered by its invasive nature, sampling error and observer variability. Elastography is a noninvasive quantitative alternative that has been widely used and validated for the staging of liver fibrosis prior to treatment. Recently, increasing research interest has been focused on the role of elastography in longitudinal assessment of liver fibrosis after AVT. In this review, the basic principles, acquisition techniques, diagnostic performances, and strengths and limitations of ultrasound elastography and magnetic resonance elastography are presented. Emerging evidence regarding the use of elastography techniques for the monitoring of liver fibrosis after AVT is summarized. Current challenges and future directions are also discussed, designed to optimize the application of these techniques in clinical practice.

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Early fibrosis regression by shear wave elastography after successful direct-acting anti-HCV therapy

Cited by 13 publications

References 23 publications

Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study

Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study

Tomoelastography for Longitudinal Monitoring of Viscoelasticity Changes in the Liver and in Renal Allografts after Direct-Acting Antiviral Treatment in 15 Kidney Transplant Recipients with Chronic HCV Infection

Elastography for Longitudinal Assessment of Liver Fibrosis after Antiviral Therapy: A Review

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