Longitudinal evaluation of liver stiffness and outcomes in patients with chronic hepatitis C before and after short- and long-term IFN-free antiviral treatment.
Background: New direct-acting antiviral drugs can eradicate hepatitis C virus (HCV) infection in over 90% of patients and can even reduce the risk of complications in advanced fibrosis/cirrhosis. The aims of this study were to evaluate (1) changes in fibrosis during and after antiviral treatment and (2) incidence of hepatocarcinoma and mortality in various fibrosis stages.Methods: This is a longitudinal monocentric prospective study. Blood and instrumental examinations were evaluated at baseline, at the end of therapy, and 1 and 2 years following treatment.Results: Two hundred and ninety-six patients with chronic HCV were evaluated, of whom 115 were experienced, 181 were treatment-naïve, and 2 had previous hepatocellular carcinoma (HCC) and were therefore excluded from the study. At baseline, stiffness values were 13.46 ± 9.97 kPa. Out of the 294 HCV patients enrolled, 100 had lymphoproliferative disorders and were evaluated separately. This group of patients showed stiffness values pertaining to the F0-F2 group (mean stiffness values were 6.07 ± 1.68 kPa). All other patients showed stiffness values pertaining to the F3-F4 group (mean stiffness values were 17.93 ± 10.23). No statistically significant difference was found between stiffness at baseline compared to the end of treatment (EOT), while significant differences were found between the baseline, 1 year (p = .05), and 2 year follow-ups (p < .01). Significant differences were found between baseline and EOT, as well as 1 and 2 years after the end of treatment (p < .001) in the F3-F4 group. Four out of 140 patients with baseline cirrhosis developed HCC during the post-treatment follow-up, 1 of whom died.Conclusions: Non-invasive methods provide important prognostic information, particularly concerning the observed regression of fibrosis and could be extremely useful for monitoring patients with long life expectancies after direct-acting antiviral treatment.
['Stasi|Cristina|C|0000-0002-9146-9968', 'Sadalla|Sinan|S|0000-0001-5336-317X', 'Carradori|Eleonora|E|0000-0002-4161-1364', 'Monti|Monica|M|0000-0001-5990-0677', 'Petraccia|Luisa|L|0000-0001-7171-3428', 'Madia|Francesco|F|0000-0001-5746-6475', 'Gragnani|Laura|L|0000-0001-6800-9149', 'Zignego|Anna Linda|AL|0000-0002-8552-4166']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000998:Antiviral Agents D006528:Carcinoma, Hepatocellular D005260:Female D019698:Hepatitis C, Chronic D006801:Humans D008103:Liver Cirrhosis D008113:Liver Neoplasms D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D011446:Prospective Studies
chronic hepatitis C direct-acting antiviral drugs Fibrosis elastography