Fibrosis Evaluation by Transient Elastography in Patients With Long-Term Sustained HCV Clearance
| Author | Vincenza Calvaruso | en |
| Author | Vito Di Marco | en |
| Author | Donatella Ferraro | en |
| Author | Salvatore Petta | en |
| Author | Anna Calì | en |
| Author | Maria Grazia Bavetta | en |
| Author | Elisabetta Conte | en |
| Author | Piero Luigi Almasio | en |
| Issued Date | 2013-05-01 | en |
| Abstract | Background: Reversibility of advanced fibrosis after HCV-clearance is an important goal of therapy. Objectives: Measuring liver stiffness (LS) by transient elastography (TE) might be helpful in this setting. Patients and Methods: We evaluated 104 patients with biopsy-proven chronic hepatitis C (CHC) and sustained virological response (SVR) after Peg-Interferon (IFN) plus ribavirin since at least 18 months. HCV-eradication was confirmed searching for serum HCV-RNA (TMA® sensitivity > 5-10 IU/ml). Data from literature reported the best LS cut-off values for different stages of liver fibrosis were 7.1 kPa for Metavir stage 2 (F2), 9.5 kPa for F3 and 12.5 for cirrhosis (F4). Results: TE was not reliable in four SVR obese patients. Metavir-stage of biopsy was F0-1 in 28, F2 in 47, F3 in 17 and F4 in eight patients. The median interval elapsed since achieving SVR was 36 months (range: 18-77, SD¬¬:18). Stratifying patients according to the histological stage assessed before treatment, a clear-cut gradient of LS values was observed from F0-1: median: 3.8 kPa (range: 3.5-4.9) to F2: 4.6 kPa (3.8-6.0), F3: 6.2 kPa (4.8-8.6) and F4: 8.4 kPa (6.2-9.2) (P = 0.001). Overall, 86 patients had lower values of LS than the expected LS values according to Metavir-stage. At multivariate logistic analysis γ-GT and histological steatosis were independently associated with persistence of higher values of LS. Conclusion: Long term responders to IFN-based therapies have lower LS values than those who are untreated and still viraemic. High levels of γ-GT and liver steatosis, all markers of insulin resistance, may hamper reduction of liver stiffness after HCV-clearance. | en |
| DOI | https://doi.org/10.5812/hepatmon.7176 | en |
| Keyword | Liver Cirrhosis | en |
| Keyword | Elasticity Imaging Techniques | en |
| Keyword | Insulin Resistance | en |
| Publisher | Brieflands | en |
| Title | Fibrosis Evaluation by Transient Elastography in Patients With Long-Term Sustained HCV Clearance | en |
| Type | Research Article | en |
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