Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 16;10(17):5566-5576.
doi: 10.12998/wjcc.v10.i17.5566.

Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis C patients

Anya Mezina  1 , Arunkumar Krishnan  2 , Tinsay A Woreta  2 , Kevin B Rubenstein  3 , Eric Watson  3 , Po-Hung Chen  2 , Carla Rodriguez-Watson  3
Affiliations

Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis C patients

Anya Mezina et al. World J Clin Cases. .

Abstract

Background: Liver fibrosis is a common pathway of liver injury and is a feature of most chronic liver diseases. Fibrosis progression varies markedly in patients with hepatitis C virus (HCV). Liver stiffness has been recommended as a parameter of fibrosis progression/regression in patients with HCV.

Aim: To investigate changes in liver stiffness measured by transient elastography (TE) in a large, racially diverse cohort of United States patients with chronic hepatitis C (CHC).

Methods: We evaluated the differences in liver stiffness between patients treated with direct-acting antiviral (DAA) therapy and untreated patients. Patients had ≥ 2 TE measurements and no prior DAA exposure. We used linear regression to measure the change in liver stiffness between first and last TE in response to treatment, controlling for age, sex, race, diabetes, smoking status, human immunodeficiency virus status, baseline alanine aminotransferase, and baseline liver stiffness. Separate regression models analyzed the change in liver stiffness as measured by kPa, stratified by cirrhosis status.

Results: Of 813 patients, 419 (52%) initiated DAA treatment. Baseline liver stiffness was 12 kPa in 127 (16%). Median time between first and last TE was 11.7 and 12.7 mo among treated and untreated patients, respectively. There was no significant change in liver stiffness observed over time in either the group initiating DAA treatment (0.016 kPa/month; CI: -0.051, 0.084) or in the untreated group (0.001 kPa/mo; CI: -0.090, 0.092), controlling for covariates. A higher baseline kPa score was independently associated with decreased liver stiffness.

Conclusion: DAA treatment was not associated with a differential change in liver stiffness over time in patients with CHC compared to untreated patients.

Keywords: Chronic hepatitis C; Cirrhosis; Direct-acting antiviral therapy; Liver stiffness; Transient elastography.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.

Figures

Figure 1
Figure 1
Change in liver stiffness between first and last transient elastography measurement in patients with chronic hepatitis C infection. Scatter plot illustrating the difference in liver stiffness (kPa) between the first and last transient elastography measurement for patients who were treated (n = 405) and not treated (n = 365) with direct-acting antiviral therapy for chronic hepatitis C infection during the study period. Circles correspond to values for individual patients. kPa: Kilopascals; TE: Transient elastography.
See this image and copyright information in PMC

References

    1. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006;45:529–538. - PubMed
    1. Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017;2:161–176. - PubMed
    1. Singh S, Fujii LL, Murad MH, Wang Z, Asrani SK, Ehman RL, Kamath PS, Talwalkar JA. Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11:1573–84.e1. - PMC - PubMed
    1. Bedossa P, Poynard T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group. Hepatology. 1996;24:289–293. - PubMed
    1. Thein HH, Yi Q, Dore GJ, Krahn MD. Estimation of stage-specific fibrosis progression rates in chronic hepatitis C virus infection: a meta-analysis and meta-regression. Hepatology. 2008;48:418–431. - PubMed