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Clinical Trial
. 2012;7(10):e47715.
doi: 10.1371/journal.pone.0047715. Epub 2012 Oct 17.

Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy

Stella M Martinez  1 , Juliette Foucher, Jean-Marc Combis, Sophie Métivier, Maurizia Brunetto, Dominique Capron, Marc Bourlière, Jean-Pierre Bronowicki, Thong Dao, Marianne Maynard-Muet, Damien Lucidarme, Wassil Merrouche, Xavier Forns, Victor de Lédinghen
Affiliations
Clinical Trial

Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy

Stella M Martinez et al. PLoS One. 2012.

Abstract

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.

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Conflict of interest statement

Competing Interests: Victor de Lédinghen receives consulting fees from Merck, Roche, Gilead, Janssen, Echosens and Bayer. Xavier Forns receives unrestricted grant support from Roche and MSD. Juliette Foucher is on the advisory board for Janssen. Thông Dao is a board member for Schering Plough and receives consulting fees from Roche and Gilead. Jean Marc Combis is employed by Clinique Ambroise Paré. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Liver stiffness evolution in treated vs untreated patients: Significant changes over time in treated vs untreated patients.
Figure 2
Figure 2. Mean percentage of change in liver stiffness from baseline to end of study according to treatment and virologic response.
Figure 3
Figure 3. Liver stiffness evolution in patients with measurements above the cut-off value for advanced fibrosis and cirrhosis according to virologic response.
The y axis is in logarithmic scale. The black dots indicate the mean liver stiffness value at each time points.
See this image and copyright information in PMC

References

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