Longitudinal assessment of liver stiffness in patients undergoing antiviral treatment for hepatitis C

Abstract

Background: Liver stiffness has been suggested as a parameter of fibrosis progression/regression in hepatitis C virus (HCV) patients.

Aim: To evaluate stiffness before and after peginterferon-ribavirin treatment.

Methods: Stiffness was prospectively measured in 74 HCV patients, 32 genotypes 1/4 (43.25%) and 42 genotypes 2/3 (56.75%), before, at end of treatment, and after 3 years of follow-up (49 patients). On the same study day, 21 patients underwent liver biopsy.

Results: In 55 patients with sustained virological response (74.32%), liver stiffness decreased significantly at end of therapy (6.8±4.9kPa) vs. baseline (9.5±6.9kPa, p=0.04). The decrease vs. baseline was maintained in 30 sustained virological response patients after 3 years follow-up (6.8±4.6kPa vs. 10.8±8.5kPa, p=0.0141). No difference was found at end of treatment vs. baseline (10.1±4.7kPa vs. 9.7±4.2kPa, p=0.825) and after 3 years of follow-up vs. baseline (10.2±3.4kPa vs. 9.7±4.2kPa, p=0.765) in null responders. Similar results were found in relapsers at end of treatment vs. baseline (13.7±7.7kPa vs. 15.2±8.2kPa, p=0.74), and after 3 years of follow-up vs. baseline (16.9±10.0kPa vs. 15.2±8.2kPa, p=0.734). Pre-treatment stiffness >12kPa was significantly associated with no SVR (p<0.025), RR=2.44 (95%C.I. 1.17-5.07).

Conclusion: Liver stiffness may be useful to assess long-term antiviral treatment response.

Keywords: AR; Antiviral treatment; CHC; CLD; Chronic hepatitis C; Fibrosis; HCV; IQR; Liver stiffness; NR; RR; SOC; SVR; Sustained virological response; TE; attributable risk; chronic hepatitis C; chronic liver diseases; hepatitis C virus; interquartile range; null response; relative risk; standard of care; sustained virologic response; transient elastography.