Gut Liver.  2016 May;10(3):429-436. 10.5009/gnl15021.

Predicting Liver-Related Events Using Transient Elastography in Chronic Hepatitis C Patients with Sustained Virological Response

• Lee HW
• Chon YE
• Kim SU
• Kim BK
• Park JY
• Kim DY
• Ahn SH
• Jung KS
• Park YN
• Han KH

• KMID: 2411971
• DOI: http://doi.org/10.5009/gnl15021

Abstract

BACKGROUND/AIMS
Few studies have investigated prognostic factors for the development of liver-related events (LREs) in patients with chronic hepatitis C (CHC) who achieve sustained virological response (SVR).
METHODS
We analyzed 190 patients with CHC who achieved SVR after treatment with pegylated interferon (peg-IFN) plus ribavirin. LREs were defined as any complications related to cirrhosis, hepatocellular carcinoma (HCC), or liver-related mortality.
RESULTS
The mean age was 54.1 years, and 84 of the patients (44.2%) were male. The mean liver stiffness (LS) value at SVR was 7.1±5.4 kPa. During the follow-up period (median, 43.0 months), LREs occurred in 10 patients (5.3%; HCC in eight patients, ascites in one patient, and liver-related mortality in one patient). By multivariate Cox regression analysis, age, α-fetoprotein level, and LS value were independent predictors for LRE development (all p<0.05). Patients with LS values ≥7.0 kPa had a greater risk (hazard ratio, 9.472; 95% confidence interval, 1.018 to 88.126; p=0.048) for LRE development compared to those with LS values <7.0 kPa.
CONCLUSIONS
The LS value at SVR is useful for predicting LRE development in CHC patients who achieve SVR after treatment with peg-IFN plus ribavirin. Thus, LRE surveillance strategies might be optimized according to the LS values at SVR, even with complete viral eradication.

Keyword

Hepatitis C, chronic; Carcinoma, hepatocellular; Liver stiffness; Sustained virological response; Transient elastography

MeSH Terms

Antiviral Agents/*therapeutic use
Carcinoma, Hepatocellular/complications
Drug Therapy, Combination
*Elasticity Imaging Techniques
Female
Hepatitis C, Chronic/*drug therapy
Humans
Interferon-alpha/therapeutic use
Liver Cirrhosis/complications
Liver Neoplasms/complications
Male
Middle Aged
Polyethylene Glycols/therapeutic use
Pregnancy
Recombinant Proteins/therapeutic use
Ribavirin/therapeutic use
Risk Factors
Antiviral Agents
Interferon-alpha
Recombinant Proteins
Ribavirin