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Background/Aims  Liver stiffness (LS) measurement by means of transient elastography (TE) is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC).    Methods  TE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC.    Results  323 treated (62.7%) and 192 untreated patients (37.3%) were assessed. LS experienced a significant decline in treated patients and remained stable in untreated patients at the end of study ( P <0.0001). The decline was significant for patients with baseline LS ≥ 7.1 kPa ( P< 0.0001 and  P  0.03, for LS ≥9.5 and ≥7.1 kPa  vs  lower values, respectively). Sustained virological responders and relapsers had a significant LS improvement whereas a trend was observed in nonresponders (mean percent change −16%, −10% and −2%, for SVR, RR and NR, respectively,  P  0.03 for SVR  vs  NR). In multivariate analysis, high baseline LS ( P <0.0001) and ALT levels, antiviral therapy and non-1 genotype were independent predictors of LS improvement.    Conclusions  LS decreases during and after antiviral treatment in patients with CHC. The decrease is significant in sustained responders and relapsers (particularly in those with high baseline LS) and suggests an improvement in liver damage.

Longitudinal Liver Stiffness Assessment in Patients with Chronic Hepatitis C Undergoing Antiviral Therapy