Shear wave elastography in hepatitis C patients before and after antiviral therapy

Abstract

AIMTo investigate shear wave (SW) propagation velocity in patients with untreated hepatitis C and patients with sustained virological response (SVR).METHODSA total of 136 hepatitis C patients [85 patients who had not received antiviral therapy (naïve group) and 51 patients who had received antiviral therapy and subsequently achieved SVR of at least 24 wk (SVR group)] and 58 healthy volunteers and outpatients without liver disease (control group) underwent evaluation of liver stiffness by SW elastography (SWE). Various parameters were evaluated in the chronic hepatitis C patients at the time of SWE.RESULTSSW propagation velocity (Vs) was 1.23 ± 0.14 m/s in the control group, 1.56 ± 0.32 m/s in the SVR group, and 1.69 ± 0.31 m/s in the naïve group. Significant differences were seen between the control group and the SVR group (P = 0.0000) and between the SVR group and the naïve group (P = 0.01417). All four fibrosis markers were higher in the naïve group than in the SVR group. In the naïve group, Vs was positively correlated with alanine aminotransferase (ALT) (r = 0.5372), α feto protein (AFP) (r = 0.4389), type IV collagen (r = 0.5883), procollagen III peptide (P-III-P) (r = 0.4140), hyaluronic acid (r = 0.4551), and Mac-2 binding protein glycosylation isomer (M2BPGi) (r = 0.6092) and negatively correlated with albumin (r = -0.4289), platelets (r = -0.5372), and prothrombin activity (r = -0.5235). On multiple regression analysis, Vs was the most strongly correlated with ALT (standard partial regression std β = 0.4039, P = 0.00000). In the SVR group, Vs was positively correlated with AFP (r = 0.6977), type IV collagen (r = 0.5228), P-III-P (r = 0.5812), hyaluronic acid (r = 0.5189), and M2BPGi (r = 0.6251) and negatively correlated with albumin (r = -0.4283), platelets (r = -0.4842), and prothrombin activity (r = -0.4771). On multiple regression analysis, Vs was strongly correlated with AFP (standard partial regression std β = 0.5953, P = 0.00000) and M2BPGi (standard partial regression std β= 0.2969, P = 0.03363).CONCLUSIONIn hepatitis C patients, liver stiffness is higher in treatment-naïve patients than in those showing SVR. SWE may be a predictor of hepatocarcinogenesis in SVR patients.

Accuracy of 2D shear wave elastography in the diagnosis of liver fibrosis in patients with chronic hepatitis C

“…Furthermore, the SWV was significantly negatively correlated with Plt and Alb but significantly positively correlated with T.Bil, AST, ALT, PT, HA, IV‐c‐7S and M2BPGi. These results are consistent with previous reports and show that liver stiffness measurements are associated with several complex factors of the liver, not just fibrosis but also inflammation …”

“…These results are consistent with previous reports and show that liver stiffness measurements are associated with several complex factors of the liver, not just fibrosis but also inflammation. [35][36][37][38] Several limitations associated with the present study warrant discussion. First, the study included a relatively small number of patients.…”

Efficacy of daclatasvir plus asunaprevir in patients with hepatitis C virus infection undergoing and not undergoing hemodialysis

“…Patients with advanced liver disease have a lower response to DAA therapy . Alpha‐fetoprotein level is probably associated with liver stiffness . Therefore, AFP levels are linked to the efficacy of treatment with daclatasvir plus asunaprevir.…”

Shear wave elastography predicts hepatocellular carcinoma risk in hepatitis C patients after sustained virological response

“…Because inflammation was improved at SVR24, it appears that SWE results at SVR24 provide a clear evaluation of liver fibrosis. Furthermore, a recent study suggested that SWE provides an accurate evaluation of liver fibrosis in patients who had achieved SVR [ 28 ].…”