Universität zu Köln

Knop, Viola, Mauss, Stefan, Goeser, Tobias, Geier, Andreas, Zimmermann, Tim, Herzer, Kerstin, Postel, Nils, Friedrich-Rust, Mireen and Hofmann, Wolf Peter (2020). Dynamics of liver stiffness by transient elastography in patients with chronic hepatitis C virus infection receiving direct-acting antiviral therapy-Results from the German Hepatitis C-Registry. J. Viral Hepatitis, 27 (7). S. 690 - 699. HOBOKEN: WILEY. ISSN 1365-2893

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Abstract

The impact of direct-acting antiviral (DAA) therapies on fibrosis regression remains uncertain. In the current study, we prospectively evaluated dynamics of liver stiffness by transient elastography (TE) in patients with chronic HCV infection receiving DAA-based treatment. Patients (260) were enrolled in the German Hepatitis C-Registry (DHC-R), a national multicentre real-world cohort. Liver stiffness (LS) was assessed at baseline, end of treatment (EOT) and 24 weeks after EOT (FU24) by TE. Biochemical, virological and clinical data were obtained in parallel. In patients with SVR, there was a significant improvement of LS between baseline (median [range], 8.6 [1.7-73.5] kPa) and FU24 (7.9 [1.7-75 kPa];P < .0001) as well as between EOT (8.4 [1.7-73.5 kPa]) and FU24 [P < .0001]. Stratified by fibrosis stage, patients classified into F4 had higher magnitude of LS reduction between BL (median [range], 25.1 [13.5-73.5] kPa) and FU24 (21.5 [3.1-75] kPa;P = .002) compared to those with F2-F3 (8.9 [7.1-12.4] kPa and 8.8 [4.2-29.1];P = .060) or F0-F1 (5.3 [1.7-7] kPa and 5.2 [1.7-7.7];P = .064). In cirrhotic patients, low platelets were significantly associated with lack of liver stiffness improvement, both at EOT (P = .018) and at FU24 (P = .012). LS significantly correlated with ALT (r = .371), AST (r = .552), platelets (r = -.499), GGT (r = .250), bilirubin (r = .230), APRI score (r = .512), FIB-4 score (r = .517) and FORNS index (r = .562);P < .0001. Liver elastography improved significantly in our real-world cohort after DAA-based therapy. As LS correlates similarly with transaminase levels and serum fibrosis markers, it might reflect both reduction of necroinflammation and fibrosis regression.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Knop, Viola UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauss, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Geier, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Zimmermann, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Herzer, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Postel, Nils UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrich-Rust, Mireen UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofmann, Wolf Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-328518
DOI:	10.1111/jvh.13280
Journal or Publication Title:	J. Viral Hepatitis
Volume:	27
Number:	7
Page Range:	S. 690 - 699
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1365-2893
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FIBROSIS; HCV; REGRESSION; CIRRHOSIS; METAANALYSIS; PROGRESSION; DISEASE; CURE Multiple languages Gastroenterology & Hepatology; Infectious Diseases; Virology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32851