Dynamics of liver stiffness by transient elastography in patients with chronic hepatitis C virus infection receiving direct-acting antiviral therapy-Results from the German Hepatitis C-Registry.
chronic hepatitis C
direct-acting antiviral (DAA) treatment
transient elastography
Journal
Journal of viral hepatitis
ISSN: 1365-2893
Titre abrégé: J Viral Hepat
Pays: England
ID NLM: 9435672
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
12
08
2019
revised:
20
01
2020
accepted:
09
02
2020
pubmed:
26
2
2020
medline:
12
8
2021
entrez:
26
2
2020
Statut:
ppublish
Résumé
The impact of direct-acting antiviral (DAA) therapies on fibrosis regression remains uncertain. In the current study, we prospectively evaluated dynamics of liver stiffness by transient elastography (TE) in patients with chronic HCV infection receiving DAA-based treatment. Patients (260) were enrolled in the German Hepatitis C-Registry (DHC-R), a national multicentre real-world cohort. Liver stiffness (LS) was assessed at baseline, end of treatment (EOT) and 24 weeks after EOT (FU24) by TE. Biochemical, virological and clinical data were obtained in parallel. In patients with SVR, there was a significant improvement of LS between baseline (median [range], 8.6 [1.7-73.5] kPa) and FU24 (7.9 [1.7-75 kPa]; P < .0001) as well as between EOT (8.4 [1.7-73.5 kPa]) and FU24 [P < .0001]. Stratified by fibrosis stage, patients classified into F4 had higher magnitude of LS reduction between BL (median [range], 25.1 [13.5-73.5] kPa) and FU24 (21.5 [3.1-75] kPa; P = .002) compared to those with F2-F3 (8.9 [7.1-12.4] kPa and 8.8 [4.2-29.1]; P = .060) or F0-F1 (5.3 [1.7-7] kPa and 5.2 [1.7-7.7]; P = .064). In cirrhotic patients, low platelets were significantly associated with lack of liver stiffness improvement, both at EOT (P = .018) and at FU24 (P = .012). LS significantly correlated with ALT (r = .371), AST (r = .552), platelets (r = -.499), GGT (r = .250), bilirubin (r = .230), APRI score (r = .512), FIB-4 score (r = .517) and FORNS index (r = .562); P < .0001. Liver elastography improved significantly in our real-world cohort after DAA-based therapy. As LS correlates similarly with transaminase levels and serum fibrosis markers, it might reflect both reduction of necroinflammation and fibrosis regression.
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
690-698Investigateurs
Katrin Ende
(K)
Anita Pathil
(A)
Tilman Bauer
(T)
Stefan Zeuzem
(S)
Thomas Berg
(T)
Markus Cornberg
(M)
Norbert Börner
(N)
Marc Ringelhan
(M)
Hartwig Klinker
(H)
Thorsten Schlenker
(T)
Thomas Lutz
(T)
Hauke Heinzow
(H)
Rainer Günther
(R)
Heiner Busch
(H)
Axel Baumgarten
(A)
Peter Buggisch
(P)
Martin Roessle
(M)
Dietrich Hüppe
(D)
Michael P Manns
(MP)
Claus Niederau
(C)
Christoph Sarrazin
(C)
Peter Schirmacher
(P)
Karl-Georg Simon
(KG)
Heiner Wedemeyer
(H)
Informations de copyright
© 2020 John Wiley & Sons Ltd.
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