Liver stiffness diminishes with antiviral response in chronic hepatitis C

Hézode, Christophe; Castéra, Laurent; Roudot‐Thoraval, Françoise; Bouvier‐Alias, Magali; Rosa, Isabelle; Roulot, Dominique; Leroy, Vincent; Mallat, Ariane; Pawlotsky, Jean‐Michel

doi:10.1111/j.1365-2036.2011.04765.x

Cited by 126 publications

(116 citation statements)

References 45 publications

(62 reference statements)

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“…This observation has already been made in earlier studies [35][36][37][38][39]. In our cohort, the range of changes in kPa was −4.2 to 41.8 kPa between baseline and FU24, 2.3 kPa to 29 kPa between baseline and FU96, and −2.6 to 18.7 between EOT and FU96.…”

Section: Discussionsupporting

confidence: 70%

“…In the Arima et al study, patients treated with pegylated interferon (pegIFN) and RBV were followed, observing a mean LS drop by 5.3 (4.1-6.3) kPa in two-year follow-up [37]. However, in the Hezode et al study, the median decrease compared to baseline at the end of follow-up was 3.4 kPa, vs. 1.8 kPa in the patients who did not achieve an SVR [38]. Due to the 100% effectiveness of treatment in our cohort, we were unable to determine such a relationship.…”

Section: Discussionmentioning

confidence: 82%

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Effect of HCV Core Antigen and RNA Clearance during Therapy with Direct Acting Antivirals on Hepatic Stiffness Measured with Shear Wave Elastography in Patients with Chronic Viral Hepatitis C

Łucejko

Flisiak

2018

Applied Sciences

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Abstract:To assess a combination of novel measures of therapeutic success in the treatment of chronic hepatitis C (CHC) infection, we evaluated liver stiffness (LS) with shear wave elastography and hepatitis C virus core antigen (HCVcAg) concentrations. We followed 34 patients during and after treatment with direct acting antivirals. All patients achieved a sustained virologic and serologic response and a significant increase of albumin levels. Decreases of alanine aminotransferase (ALT) activity and alpha-fetoprotein (AFP) level were observed during the treatment and follow-up period. A significant decrease in LS was observed between baseline, end of treatment (EOT), and at 24-and 96-week post-treatment follow-up. LS decline between EOT and 96-week follow-up (FU96) was observed in 79% of patients. Significant LS changes were seen in patients with advanced fibrosis, particularly in cirrhotics and in patients with ALT exceeding 100 IU/mL. There was a positive correlation between ALT activity and LS changes at the baseline versus FU96. A negative correlation was demonstrated between individual HCVcAg baseline concentrations and reduction of LS at the baseline versus FU96. In conclusion, we observed that LS significantly declined during and after antiviral treatment. It was accompanied by improvement in some liver function measures, and disappearance of both HCVcAg and HCV ribonucleic acid (HCV RNA).

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 82%

Effect of HCV Core Antigen and RNA Clearance during Therapy with Direct Acting Antivirals on Hepatic Stiffness Measured with Shear Wave Elastography in Patients with Chronic Viral Hepatitis C

Łucejko

Flisiak

2018

Applied Sciences

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“…1 The problem is that the liver stiffness value is a function of fibrosis and necroinflammation 2 and that liver stiffness may decrease when the latter is controlled. 3 In our center, 627 patients with chronic hepatitis B viral infection underwent liver stiffness measurement between 2006 and 2014 and 16 (2.5%) developed hepatocellular carcinoma after a median follow-up of 35 (interquartile range 17-65) months. Considering the entire cohort, the liver stiffness value was correlated to hepatocellular carcinoma development with an area under the receiver operating characteristic curve of 0.87 (P < 0.0001).…”

Section: Patients With Chronic Hepatitis B Should Be Screened For Hepmentioning

confidence: 99%

Patients with chronic hepatitis B should be screened for hepatocellular carcinoma regardless of liver stiffness measurement

et al. 2015

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“…Preliminary study results indicate that the acoustic radiation force impulse (ARFI) elastography is a noninvasive method for measuring liver stiffness (LS) and can be used for the diagnosis of liver fibrosis and cirrhosis in chronic liver disease 17, 18, 19, 20, 21, 22, 23. However, the relationship between LS and its impact on the development of HCC remains unclear in chronic hepatitis C patients who achieved SVR following DAA therapy.…”

Section: Introductionmentioning

confidence: 99%

Liver stiffness measurement predicts hepatocellular carcinoma development in patients treated with direct‐acting antivirals

et al. 2017

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Background and AimPredictive factors for hepatocarcinogenesis following eradication of hepatitis C virus by direct‐acting antivirals (DAAs) are unknown. The aim of the study was to investigate the relationships between liver stiffness (LS) using acoustic radiation force impulse (ARFI) erastograghy and the development of hepatocellular carcinoma (HCC) in patients who achieved sustained virological response (SVR) treated with DAA.MethodsIn this prospective study, we enrolled 263 hepatitis C patients with SVR who underwent ARFI before DAA treatment. Thirty patients had previous HCC.ResultsThe median LS value according to ARFI measurements was 1.34 m/s (range: 0.67–4.35). During the follow‐up period (median: 18.1 months), development of HCC occurred in 19 patients (7.2%; HCC occurrence in 7 patients and HCC recurrence in 12 patients). By multivariate Cox regression analysis, HCC history (hazard ratio [HR]: 10.634; 95% confidence interval [CI]: 4.13–27.37; P = 0.001), older age (HR: 4.638; 95% CI: 1.63–13.61; P = 0.004) and higher total bilirubin levels (HR: 4.189; 95% CI: 1.66–10.60; P = 0.002) were independent predictors for the development of HCC, and higher LS value (≥1.73 m/s) at baseline was an independent predictor for HCC occurrence (HR: 8.350; 95% CI: 1.62–43.09; P = 0.011). The cumulative recurrence of HCC was statistically similar according to the degree of LS in patients who were previously treated for HCC.ConclusionThe LS value at baseline is useful for predicting HCC occurrence. Thus, even if SVR is achieved, patients with higher LS at baseline must be followed carefully for HCC occurrence.

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Liver stiffness diminishes with antiviral response in chronic hepatitis C

Abstract: SUMMARY BackgroundTransient elastography measures liver stiffness, which correlates with the hepatic fibrosis stage and has excellent accuracy for the diagnosis of cirrhosis in patients with chronic hepatitis C.

Cited by 126 publications

References 45 publications

Effect of HCV Core Antigen and RNA Clearance during Therapy with Direct Acting Antivirals on Hepatic Stiffness Measured with Shear Wave Elastography in Patients with Chronic Viral Hepatitis C

Effect of HCV Core Antigen and RNA Clearance during Therapy with Direct Acting Antivirals on Hepatic Stiffness Measured with Shear Wave Elastography in Patients with Chronic Viral Hepatitis C

Patients with chronic hepatitis B should be screened for hepatocellular carcinoma regardless of liver stiffness measurement

Liver stiffness measurement predicts hepatocellular carcinoma development in patients treated with direct‐acting antivirals

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