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Long‐term liver stiffness assessment in hepatitis C virus patients undergoing antiviral therapy: Results from a 5‐year cohort study
Author(s) -
Facciorusso Antonio,
Del Prete Valentina,
Turco Antonio,
Buccino Rosario Vincenzo,
Nacchiero Maurizio Cosimo,
Muscatiello Nicola
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14008
Subject(s) - medicine , cohort , antiviral therapy , hepatitis c virus , cohort study , virology , virus , chronic hepatitis
Background and Aim Observational studies showed significant liver stiffness regression after sustained virological response, but long‐term effects of antiviral therapy are still unknown. The aim of this study was to assess the magnitude of change in stiffness up to 5 years after therapy in hepatitis C patients undergoing antiviral treatment. Methods Data of 153 patients were retrieved. Stiffness was assessed by Fibroscan at baseline, end of treatment, 6 months after treatment, and every year hereafter up to 5 years. Results Seventy patients were treated with interferon‐based regimens and 83 with direct antiviral agents. Baseline cirrhosis was diagnosed in 53 (34.6%) patients. Sustained virological response was achieved in 112 patients, whereas 41 were non‐responders. In responders, stiffness decreased from 12.3 kPa (9–17.8) to 6.6 kPa (5.3–7.4) at 5 years. A sharper decline was observed immediately after treatment (−2.5 kPa at the end of treatment and −3.7 kPa at 6 months), while from 1 year onwards, the magnitude of stiffness decrease was progressively lower. In non‐responders, stiffness showed a slight decrease at the end of treatment (from 19.2 to 18.1 kPa), then returned to baseline levels at 6 months (19.4 kPa), and finally increased over time up to 23.7 kPa (15–32.5) at 5 years. The proportion of cirrhotic patients decreased by 50% at 6 months and finally fell < 5% at 4 years after treatment. Conclusions Stiffness declines significantly after achieving response, and the magnitude of decline is greater in the first year after treatment, while it tends to plateau from 1 year onwards.