Short-term effect of DAA IFN-free regimens on liver stiffness

Pineda, José; Merchante, Nicolás; Mancebo, M.J.; Neukam, Karin; Rincón, Pilar; Álvarez‐Ossorio, Manuel Pan; Real, Luís Miguel; Macias, J.

doi:10.1016/s0168-8278(17)31451-4

Cited by 3 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For these reasons, current data on cirrhosis reversibility after DAA therapy are of limited value, since they are based mostly on indirect indicators of liver fibrosis, such as LS measurements. For example, in a study by Pineda et al ., among 49 patients with pre-therapeutic LS values indicating cirrhosis (> 12.5 kPa), LS decreased to values that would indicate cirrhosis reversal (< 12.5 kPa) in 12 (24%) patients after reaching an SVR12 following DAA therapy [ 19 ]. In another study in which 392 patients with chronic hepatitis C were treated with DAA, regression of LS was noted, from an average of 12.65 kPa prior to therapy to 8.55 kPa 40 weeks after achieving an SVR, which is a reduction of 32% ( p < 0.001); meanwhile, the FIB4 score regressed from 2.5 to 1.8 [ 20 ].…”

Section: Cirrhosis Reversibility By Direct-acting Antiviralsmentioning

confidence: 99%

Hepatitis C is now curable, but what happens with cirrhosis and portal hypertension afterwards?

Grgurević

Božin

Madir

2017

ceh

View full text Add to dashboard Cite

Results from the interferon era have demonstrated reversibility of cirrhosis following viral eradication, but only for patients in the initial stage of cirrhosis. Although direct-acting antivirals (DAA) represent revolutionary treatment of hepatitis C, there are currently no studies showing histological effects of therapy on a large number of cirrhotic patients. However, studies involving transient elastography demonstrated a rapid decrease in liver stiffness after successful DAA therapy, probably due to resolution of inflammation, rather than fibrosis regression, as the latter requires a longer period of time. Reversal of fibrosis and cirrhosis upon viral eradication is a prerequisite for the reduction of portal pressure, but this effect has only been observed for the subclinical stage of portal hypertension (PH). On the other hand, the majority of patients with clinically significant PH remain at risk of decompensation and death, despite hepatitis C virus cure, as PH remains high in this setting. This calls for novel therapeutic approaches.

show abstract

Section: Cirrhosis Reversibility By Direct-acting Antiviralsmentioning

confidence: 99%