Liver stiffness measurements in chronic hepatitis C: Treatment evaluation and risk assessment.
Aged
Antiviral Agents
/ therapeutic use
Carcinoma, Hepatocellular
/ etiology
Cohort Studies
Elasticity
Elasticity Imaging Techniques
/ methods
Female
Fibrosis
Hepatitis C, Chronic
/ complications
Humans
Liver
/ pathology
Liver Neoplasms
/ etiology
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Assessment
HCV treatment
hepatitis C, clinical
hepatocellular carcinoma, clinical
liver stiffness measurement
Journal
Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
21
01
2018
revised:
21
10
2018
accepted:
23
10
2018
pubmed:
6
11
2018
medline:
27
11
2019
entrez:
6
11
2018
Statut:
ppublish
Résumé
Liver stiffness (LS), measured by transient elastography, has been validated as a non-invasive surrogate for liver fibrosis. We investigated the long-term predictive ability of LS for hepatocellular carcinoma (HCC) development and overall survival in 1146 patients with chronic hepatitis C by using LS value at enrollment. We also investigated chronological changes in LS based on antiviral therapy and its outcome in 752 patients. During the mean follow-up period of 6.6 years, 190 patients developed HCC. Cumulative HCC incidence rates at 5 years were clearly stratified as 1.7% in the ≤ 5 kPa, 3.3% in 5.1-10 kPa, 16.7% in 10.1-15 kPa, 24.4% in 15.1-20 kPa, 36.3% in 20.1-25 kPa, and 43.7% in > 25 kPa subgroups (P < 0.001). Overall survival was also stratified: 10-year survival rates were 99.3% in the ≤ 5 kPa, 95.4% in 5.1-10 kPa, 81.4% in 10.1-15 kPa, 79.5% in 15.1-20 kPa, 66.1% in 20.1-25 kPa, and 49.1% in > 25 kPa subgroups (P < 0.001). LS decreased at a rate of 8.1% per year in those who achieved sustained virological responses, but increased at 0.1% per year in those who could not achieve sustained virological response instead of antiviral therapy, and increased at 3.7% per year in those who did not undergo antiviral therapy. Liver stiffness measurements can be useful in the prediction of HCC development and overall survival and in the evaluation of chronological changes in liver fibrosis grade during and after antiviral therapy.
Sections du résumé
BACKGROUND AND AIM
OBJECTIVE
Liver stiffness (LS), measured by transient elastography, has been validated as a non-invasive surrogate for liver fibrosis.
METHODS
METHODS
We investigated the long-term predictive ability of LS for hepatocellular carcinoma (HCC) development and overall survival in 1146 patients with chronic hepatitis C by using LS value at enrollment. We also investigated chronological changes in LS based on antiviral therapy and its outcome in 752 patients.
RESULTS
RESULTS
During the mean follow-up period of 6.6 years, 190 patients developed HCC. Cumulative HCC incidence rates at 5 years were clearly stratified as 1.7% in the ≤ 5 kPa, 3.3% in 5.1-10 kPa, 16.7% in 10.1-15 kPa, 24.4% in 15.1-20 kPa, 36.3% in 20.1-25 kPa, and 43.7% in > 25 kPa subgroups (P < 0.001). Overall survival was also stratified: 10-year survival rates were 99.3% in the ≤ 5 kPa, 95.4% in 5.1-10 kPa, 81.4% in 10.1-15 kPa, 79.5% in 15.1-20 kPa, 66.1% in 20.1-25 kPa, and 49.1% in > 25 kPa subgroups (P < 0.001). LS decreased at a rate of 8.1% per year in those who achieved sustained virological responses, but increased at 0.1% per year in those who could not achieve sustained virological response instead of antiviral therapy, and increased at 3.7% per year in those who did not undergo antiviral therapy.
CONCLUSIONS
CONCLUSIONS
Liver stiffness measurements can be useful in the prediction of HCC development and overall survival and in the evaluation of chronological changes in liver fibrosis grade during and after antiviral therapy.
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
921-928Subventions
Organisme : AMED
ID : JP18fk0210022
Organisme : AMED
ID : JP17fk0210106
Informations de copyright
© 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.