Longitudinal assessment of liver stiffness in patients undergoing antiviral treatment for hepatitis C

Background: Liver stiffness has been suggested as a parameter of fibrosis progression/regression in hepatitis C virus (HCV) patients. Aim: To evaluate stiffness before and after peginterferon-ribavirin treatment. Methods: Stiffness was prospectively measured in 74 HCV patients, 32 genotypes 1/4 (43.25%) and 42 genotypes 2/3 (56.75%), before, at end of treatment, and after 3 years of follow-up (49 patients). On the same study day, 21 patients underwent liver biopsy. Results: In 55 patients with sustained virological response (74.32%), liver stiffness decreased significantly at end of therapy (6.8 +/- 4.9 kPa) vs. baseline (9.5 +/- 6.9 kPa, p = 0.04). The decrease vs. baseline was maintained in 30 sustained virological response patients after 3 years follow-up (6.8 +/- 4.6 kPa vs. 10.8 +/- 8.5 kPa, p = 0.0141). No difference was found at end of treatment vs. baseline (10.1 +/- 4.7 kPa vs. 9.7 +/- 4.2 kPa, p = 0.825) and after 3 years of follow-up vs. baseline (10.2 +/- 3.4 kPa vs. 9.7 +/- 4.2 kPa, p = 0.765) in null responders. Similar results were found in relapsers at end of treatment vs. baseline (13.7 +/- 7.7 kPa vs. 15.2 perpendicular to 8.2 kPa, p = 0.74), and after 3 years of follow-up vs. baseline (16.9 perpendicular to 10.0 kPa vs. 15.2 perpendicular to 8.2 kPa, p = 0.734). Pre-treatment stiffness > 12 kPa was significantly associated with no SVR (p < 0.025), RR = 2.44 (95% C. I. 1.17-5.07). Conclusion: Liver stiffness may be useful to assess long-term antiviral treatment response. (C) 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.