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
. 2024 Sep 10;16(9):1439.
doi: 10.3390/v16091439.

Prediction of Clinical Trajectory in HCV-Related ACLD after SVR: Role of Liver Stiffness in a 5-Years Prospective Study

Filomena Morisco  1   2   3 , Alessandro Federico  4 , Massimo Marignani  5   6 , Flavia L Lombardo  7 , Valentina Cossiga  1   2 , Luisa Ranieri  1   2 , Mario Romeo  4 , Marina Cipullo  4 , Paola Begini  5 , Alessandra Zannella  5 , Tommaso Stroffolini  8
Affiliations

Prediction of Clinical Trajectory in HCV-Related ACLD after SVR: Role of Liver Stiffness in a 5-Years Prospective Study

Filomena Morisco et al. Viruses. .

Abstract

The prediction of liver-related events (LRE) after sustained virological response (SVR) in HCV-advanced chronic liver disease (ACLD) patients is crucial. We aimed to evaluate incidence and risk factors of LRE in HCV-cirrhotic patients after SVR and to assess dynamic changes of liver stiffness in participants without LRE at the end of follow-up. We enrolled 575 consecutive patients with HCV-ACLD treated with DAAs and followed up for 5 years after SVR12. Overall, 98 (17%) patients developed any type of event, and HCC was the most frequent LRE. The incidence rate was 1.6 per 100 person-years (p/y) for both HCC and hepatic decompensation. Baseline LSM ≥ 20 kPa was the only independent predictor of hepatic decompensation, while LSM ≥ 20 kPa and male sex were independent predictors of HCC development. Among the 341 participants without LRE and with paired LSM, any LSM reduction was observed in 314 (92.1%), and half of them showed a decrease of LSM ≥ 20%. Among patients without LRE, 27.3% of participants without ≥20% LSM decrease at 2 years achieved the 5-year goal; in contrast, 31.6% of participants with ≥20% LSM decrease at 2 years lost it at 5 years. These findings provide evidence that baseline LSM is a tool to stratify patients at risk of developing LRE; the dynamic changes of LSM value suggest the need for monitoring this parameter over time.

Keywords: HCC; HCV; LSM; SVR; direct-acting antiviral.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cumulative incidence of liver decompensation (A) and HCC (B) in cirrhotic patients according to the value of stiffness at baseline (Kaplan–Meier estimates).
Figure 2
Figure 2
Dynamics of liver stiffness in patients without LRE at T24 and T60.
Figure 3
Figure 3
Changes over time in fibrosis degree from 2 to 5 years of follow-up in SVR patients without LRE.
See this image and copyright information in PMC

References

    1. Carrat F., Fontaine H., Dorival C., Simony M., Diallo A., Hezode C., De Ledinghen V., Larrey D., Haour G., Bronowicki J.-P., et al. Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: A prospective cohort study. Lancet. 2019;393:1453–1464. doi: 10.1016/S0140-6736(18)32111-1. - DOI - PubMed
    1. Nahon P., Bourcier V., Layese R., Audureau E., Cagnot C., Marcellin P., Guyader D., Fontaine H., Larrey D., De Lédinghen V., et al. Eradication of Hepatitis C Virus Infection in Patients with Cirrhosis Reduces Risk of Liver and Non-Liver Complications. Gastroenterology. 2017;152:142–156.e2. doi: 10.1053/j.gastro.2016.09.009. - DOI - PubMed
    1. Foster G.R., Irving W.L., Cheung M.C., Walker A.J., Hudson B.E., Verma S., McLauchlan J., Mutimer D.J., Brown A., Gelson W.T., et al. Impact of direct acting antiviral therapy in patients with chronic hepatitis C and decompensated cirrhosis. J. Hepatol. 2016;64:1224–1231. doi: 10.1016/j.jhep.2016.01.029. - DOI - PubMed
    1. D’ambrosio R., Degasperi E., Anolli M.P., Fanetti I., Borghi M., Soffredini R., Iavarone M., Tosetti G., Perbellini R., Sangiovanni A., et al. Incidence of liver- and non-liver-related outcomes in patients with HCV-cirrhosis after SVR. J. Hepatol. 2022;76:302–310. doi: 10.1016/j.jhep.2021.09.013. - DOI - PubMed
    1. Fernández-Alvarez P., Guerra-Veloz M.F., Vilches-Arenas A., Cordero-Ruíz P., Bellido-Muñoz F., Caunedo-Alvarez A., Carmona-Soria I. Dynamic Changes in Non-Invasive Markers of Liver Fibrosis Are Predictors of Liver Events after SVR in HCV Patients. Viruses. 2023;15:1251. doi: 10.3390/v15061251. - DOI - PMC - PubMed

MeSH terms

Substances