Justin Chan1,2, Neliswa Gogela3,4, Hui Zheng5,2, Sara Lammert1,2, Tokunbo Ajayi6,2, Zachary Fricker6,2, Arthur Y Kim1,2, Gregory K Robbins1,2, Raymond T Chung7,8. 1. Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Cox 5, Boston, MA, 02114, USA. 2. Harvard Medical School, Boston, MA, USA. 3. Division of Hepatology, Department of Medicine, University of Cape Town, Cape Town, South Africa. 4. Groote Schuur Hospital, Main Rd Observatory, Cape Town, 7925, South Africa. 5. Biostatistics Center, Massachusetts General Hospital, 50 Staniford St, Boston, MA, 02114, USA. 6. Gastrointestinal Unit, Liver Center, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA. 7. Gastrointestinal Unit, Liver Center, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA. rtchung@partners.org. 8. Harvard Medical School, Boston, MA, USA. rtchung@partners.org.
Abstract
BACKGROUND: Liver fibrosis stage determines risk of morbidity and mortality from chronic hepatitis C virus (HCV) infection. Prior data have shown long-term reversal of liver fibrosis, measured by vibration-controlled transient elastography (VCTE), in patients successfully treated with interferon-based therapies. AIM: Our study sought to determine the effect of treatment with modern HCV direct-acting antiviral (DAA) therapy on noninvasive liver fibrosis measurements. METHODS: A total of 70 patients had VCTE-based liver stiffness measurement (LSM) taken before treatment, directly after treatment completion, and at least 12 months after completion of DAA therapy. Our primary outcome was a >30% improvement in VCTE score at the end of follow-up, relative to baseline. RESULTS: The sustained virologic response rate in our cohort was 95.7%. In our cohort, 34 (48.6%) met the primary outcome. Those who had baseline elevated alanine aminotransferase (OR 3.27; 95% CI 1.13-9.47) and genotype 1 (OR 14.63; 95% CI 1.70-125.83) had higher odds of meeting that outcome, and this remained significant after adjusting for age, baseline body mass index, gender, baseline elevated alkaline phosphatase levels, treatment experience, liver transplant status, smoking, and baseline liver stiffness. CONCLUSION: Treatment of chronic HCV with modern DAA therapy was associated with a significant improvement in LSM by VCTE measurement, suggesting possible early improvement in liver fibrosis along with resolution of inflammation over the first year after treatment completion.
BACKGROUND:Liver fibrosis stage determines risk of morbidity and mortality from chronic hepatitis C virus (HCV) infection. Prior data have shown long-term reversal of liver fibrosis, measured by vibration-controlled transient elastography (VCTE), in patients successfully treated with interferon-based therapies. AIM: Our study sought to determine the effect of treatment with modern HCV direct-acting antiviral (DAA) therapy on noninvasive liver fibrosis measurements. METHODS: A total of 70 patients had VCTE-based liver stiffness measurement (LSM) taken before treatment, directly after treatment completion, and at least 12 months after completion of DAA therapy. Our primary outcome was a >30% improvement in VCTE score at the end of follow-up, relative to baseline. RESULTS: The sustained virologic response rate in our cohort was 95.7%. In our cohort, 34 (48.6%) met the primary outcome. Those who had baseline elevated alanine aminotransferase (OR 3.27; 95% CI 1.13-9.47) and genotype 1 (OR 14.63; 95% CI 1.70-125.83) had higher odds of meeting that outcome, and this remained significant after adjusting for age, baseline body mass index, gender, baseline elevated alkaline phosphatase levels, treatment experience, liver transplant status, smoking, and baseline liver stiffness. CONCLUSION: Treatment of chronic HCV with modern DAA therapy was associated with a significant improvement in LSM by VCTE measurement, suggesting possible early improvement in liver fibrosis along with resolution of inflammation over the first year after treatment completion.
Authors: Naveed Z Janjua; Mei Chong; Margot Kuo; Ryan Woods; Jason Wong; Eric M Yoshida; Morris Sherman; Zahid A Butt; Hasina Samji; Darrel Cook; Amanda Yu; Maria Alvarez; Mark Tyndall; Mel Krajden Journal: J Hepatol Date: 2016-11-04 Impact factor: 25.083
Authors: V Knop; D Hoppe; T Welzel; J Vermehren; E Herrmann; A Vermehren; M Friedrich-Rust; C Sarrazin; S Zeuzem; M-W Welker Journal: J Viral Hepat Date: 2016-08-08 Impact factor: 3.728
Authors: Hye Won Lee; Young Eun Chon; Seung Up Kim; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Kyu Sik Jung; Young Nyun Park; Kwang-Hyub Han Journal: Gut Liver Date: 2016-05-23 Impact factor: 4.519
Authors: Eleanor Barnes; Michael Pavlides; Arjun N A Jayaswal; Christina Levick; Jane Collier; Elizabeth M Tunnicliffe; Matthew D Kelly; Stefan Neubauer Journal: Abdom Radiol (NY) Date: 2020-11-28
Authors: Veronika Pietsch; Katja Deterding; Dina Attia; Kristina Imeen Ringe; Benjamin Heidrich; Markus Cornberg; Michael Gebel; Michael Peter Manns; Heiner Wedemeyer; Andrej Potthoff Journal: United European Gastroenterol J Date: 2018-06-27 Impact factor: 4.623