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

Anya Mezina, Arunkumar Krishnan, Tinsay A. Woreta, Kevin B. Rubenstein, Eric Watson, Po Hung Chen, Carla Rodriguez-Watson

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)5566-5576
Number of pages11
JournalWorld Journal of Clinical Cases
Volume10
Issue number17
DOIs
StatePublished - Jun 16 2022

Keywords

  • Chronic hepatitis c
  • Cirrhosis
  • Direct-acting antiviral therapy
  • Liver stiffness
  • Transient elastography

ASJC Scopus subject areas

  • General Medicine

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