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. 2016 May 23;10(3):429-36.
doi: 10.5009/gnl15021.

Predicting Liver-Related Events Using Transient Elastography in Chronic Hepatitis C Patients with Sustained Virological Response

Hye Won Lee  1   2 , Young Eun Chon  1   2 , Seung Up Kim  1   2   3 , Beom Kyung Kim  1   2   3 , Jun Yong Park  1   2   3 , Do Young Kim  1   2   3 , Sang Hoon Ahn  1   2   3   4 , Kyu Sik Jung  1   2 , Young Nyun Park  5 , Kwang-Hyub Han  1   2   3   4
Affiliations

Predicting Liver-Related Events Using Transient Elastography in Chronic Hepatitis C Patients with Sustained Virological Response

Hye Won Lee et al. Gut Liver. .

Erratum in

Abstract

Background/aims: Few studies have investigated prognostic factors for the development of liver-related events (LREs) in patients with chronic hepatitis C (CHC) who achieve sustained virological response (SVR).

Methods: We analyzed 190 patients with CHC who achieved SVR after treatment with pegylated interferon (peg-IFN) plus ribavirin. LREs were defined as any complications related to cirrhosis, hepatocellular carcinoma (HCC), or liver-related mortality.

Results: The mean age was 54.1 years, and 84 of the patients (44.2%) were male. The mean liver stiffness (LS) value at SVR was 7.1±5.4 kPa. During the follow-up period (median, 43.0 months), LREs occurred in 10 patients (5.3%; HCC in eight patients, ascites in one patient, and liver-related mortality in one patient). By multivariate Cox regression analysis, age, α-fetoprotein level, and LS value were independent predictors for LRE development (all p<0.05). Patients with LS values ≥7.0 kPa had a greater risk (hazard ratio, 9.472; 95% confidence interval, 1.018 to 88.126; p=0.048) for LRE development compared to those with LS values <7.0 kPa.

Conclusions: The LS value at SVR is useful for predicting LRE development in CHC patients who achieve SVR after treatment with peg-IFN plus ribavirin. Thus, LRE surveillance strategies might be optimized according to the LS values at SVR, even with complete viral eradication.

Keywords: Carcinoma, hepatocellular; Hepatitis C, chronic; Liver stiffness; Sustained virological response; Transient elastography.

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Figures

Fig. 1
Fig. 1
Recruitment algorithm. A total of 256 patients with chronic hepatitis C (CHC) who were treated with pegylated interferon (peg-IFN) and ribavirin were enrolled. Of these, 66 patients were excluded based on our exclusion criteria. A final total of 190 patients were selected for statistical analysis. HIV, human immunodeficiency virus; HCC, hepatocellular carcinoma; LS, liver stiffness; SVR, sustained virological response.
Fig. 2
Fig. 2
Cumulative incidence rates of liver-related event (LRE) development. The cumulative incidence rates of LRE development at 1, 2, and 3 years were 0.5%, 1.1%, and 2.1%, respectively. AFP, α-fetoprotein.
Fig. 3
Fig. 3
Cumulative incidence rates of liver-related event (LRE) development based on stratified age and liver stiffness values. The cumulative incidence rates of LRE development increased significantly in older patients (A), those with higher α-fetoprotein (AFP) levels (B), and those with higher liver stiffness (LS) values at sustained virological response (C) (log-rank test, all p<0.05).
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