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

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 enroll...

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Published in:Journal of viral hepatitis 2020-07, Vol.27 (7), p.690-698
Main Authors: Knop, Viola, Mauss, Stefan, Goeser, Tobias, Geier, Andreas, Zimmermann, Tim, Herzer, Kerstin, Postel, Nils, Friedrich‐Rust, Mireen, Hofmann, Wolf Peter, Ende, Katrin, Pathil, Anita, Bauer, Tilman, Zeuzem, Stefan, Berg, Thomas, Cornberg, Markus, Börner, Norbert, Ringelhan, Marc, Klinker, Hartwig, Schlenker, Thorsten, Lutz, Thomas, Heinzow, Hauke, Günther, Rainer, Busch, Heiner, Baumgarten, Axel, Buggisch, Peter, Roessle, Martin, Hüppe, Dietrich, Manns, Michael P., Niederau, Claus, Sarrazin, Christoph, Schirmacher, Peter, Simon, Karl‐Georg, Wedemeyer, Heiner
Format: Article
Language:English
Subjects:
Antiviral agents
Antiviral drugs
Bilirubin
chronic hepatitis C
Chronic infection
direct‐acting antiviral (DAA) treatment
Fibrosis
Hepatitis C
Interferon
Liver
Patients
Platelets
Transaminase
transient elastography
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cited_by cdi_FETCH-LOGICAL-c3530-bead6ac294a6eddef855dd87df730a51be2080294d87bedc9bb4329f051c775e3
cites cdi_FETCH-LOGICAL-c3530-bead6ac294a6eddef855dd87df730a51be2080294d87bedc9bb4329f051c775e3
container_end_page 698
container_issue 7
container_start_page 690
container_title Journal of viral hepatitis
container_volume 27
creator Knop, Viola
Mauss, Stefan
Goeser, Tobias
Geier, Andreas
Zimmermann, Tim
Herzer, Kerstin
Postel, Nils
Friedrich‐Rust, Mireen
Hofmann, Wolf Peter
Ende, Katrin
Pathil, Anita
Bauer, Tilman
Zeuzem, Stefan
Berg, Thomas
Cornberg, Markus
Börner, Norbert
Ringelhan, Marc
Klinker, Hartwig
Schlenker, Thorsten
Lutz, Thomas
Heinzow, Hauke
Günther, Rainer
Busch, Heiner
Baumgarten, Axel
Buggisch, Peter
Roessle, Martin
Hüppe, Dietrich
Manns, Michael P.
Niederau, Claus
Sarrazin, Christoph
Schirmacher, Peter
Simon, Karl‐Georg
Wedemeyer, Heiner
description 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 
doi_str_mv 10.1111/jvh.13280
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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 &lt; .0001) as well as between EOT (8.4 [1.7‐73.5 kPa]) and FU24 [P &lt; .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 &lt; .0001. Liver elastography improved significantly in our real‐world cohort after DAA‐based therapy. 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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 &lt; .0001) as well as between EOT (8.4 [1.7‐73.5 kPa]) and FU24 [P &lt; .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 &lt; .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.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32096310</pmid><doi>10.1111/jvh.13280</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7434-5218</orcidid></addata></record>
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identifier ISSN: 1352-0504
ispartof Journal of viral hepatitis, 2020-07, Vol.27 (7), p.690-698
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1365-2893
language eng
recordid cdi_proquest_miscellaneous_2364045664
source Wiley-Blackwell Read & Publish Collection
subjects Antiviral agents
Antiviral drugs
Bilirubin
chronic hepatitis C
Chronic infection
direct‐acting antiviral (DAA) treatment
Fibrosis
Hepatitis C
Interferon
Liver
Patients
Platelets
Transaminase
transient elastography
title 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
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