Background and aims: Transient elastography has been suggested as a possible tool for the non-invasive diagnosis of fibrosis in HCV patients. The aim of this study was to evaluate liver stiffness before antiviral therapy, at the end and after 3 years of follow-up and its role as a possible predictive factor of sustained virological response (SVR). Methods: Liver stiffness was measured before treatment, at the end, and after 3 years of follow-up in 55 HCV patients (32 men and 23 women, age 51.82 ± 11.41 years) treated with peginterferon and ribavirin for either 48 (genotypes 1 and 4) or 24 weeks (genotypes 2 and 3). Results: In virological null responders (12 patients, 21.8%), stiffness values before treatment did not differ from those observed at the end of both therapy or follow-up (9.71±4.26, 10.11±4.68, and 10.19±3.43 kPa, respectively). SVR (30 patients, 54.5%) had mean stiffness values before treatment (10.09±6.85 kPa) which did not differ from those at the end of treatment (8.68±6.38 kPa, p= 0.062), while a significant decrease was observed after three years of follow-up (6.76±4.58, p=0.0141 vs. baseline). In relapsers (7 patients, 12.7%), stiffness values before treatment did not differ from those observed at the end of therapy or follow-up (15.16±8.20, 13.73±7.72, 16.86±10.00kPa, respectively). Pre-treatment stiffness values >12 kPa were significantly associated with no sustained virological response (p< 0.025) with a relative risk of 2.35 (95% CI 1.21 - 4.57) and an attributable risk of 26%. Conclusions: In HCV patients, liver stiffness may be useful to assess the long-term response to treatment. Evaluation of pre-treatment liver stiffness as predictor of SVR may provide an additional tool for patient selection, although it needs to be confirmed in more extensive cohorts.
Longitudinal assessment of liver stiffness in patients undergoing antiviral treatment for hepatitis C
STASI, CRISTINA
;
2012-01-01
Abstract
Background and aims: Transient elastography has been suggested as a possible tool for the non-invasive diagnosis of fibrosis in HCV patients. The aim of this study was to evaluate liver stiffness before antiviral therapy, at the end and after 3 years of follow-up and its role as a possible predictive factor of sustained virological response (SVR). Methods: Liver stiffness was measured before treatment, at the end, and after 3 years of follow-up in 55 HCV patients (32 men and 23 women, age 51.82 ± 11.41 years) treated with peginterferon and ribavirin for either 48 (genotypes 1 and 4) or 24 weeks (genotypes 2 and 3). Results: In virological null responders (12 patients, 21.8%), stiffness values before treatment did not differ from those observed at the end of both therapy or follow-up (9.71±4.26, 10.11±4.68, and 10.19±3.43 kPa, respectively). SVR (30 patients, 54.5%) had mean stiffness values before treatment (10.09±6.85 kPa) which did not differ from those at the end of treatment (8.68±6.38 kPa, p= 0.062), while a significant decrease was observed after three years of follow-up (6.76±4.58, p=0.0141 vs. baseline). In relapsers (7 patients, 12.7%), stiffness values before treatment did not differ from those observed at the end of therapy or follow-up (15.16±8.20, 13.73±7.72, 16.86±10.00kPa, respectively). Pre-treatment stiffness values >12 kPa were significantly associated with no sustained virological response (p< 0.025) with a relative risk of 2.35 (95% CI 1.21 - 4.57) and an attributable risk of 26%. Conclusions: In HCV patients, liver stiffness may be useful to assess the long-term response to treatment. Evaluation of pre-treatment liver stiffness as predictor of SVR may provide an additional tool for patient selection, although it needs to be confirmed in more extensive cohorts.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
