Noninvasive assessment of liver fibrosis can predict clinical outcomes at late follow-up after a sustained virological response in HCV patients?
Objectives: The primary objective was to evaluate Liver-Related Events (LREs), including hepatic decompensation (ascites, hemorrhagic varices and encephalopathy) and Hepatocellular Carcinoma (HCC), as well as changes in liver stiffness during the follow-up period among patients who achieved a Sustai...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | Brasil |
| Institución: | Universidade de São Paulo (USP) |
| Repositorio: | Clinics |
| Idioma: | inglés |
| OAI Identifier: | oai:revistas.usp.br:article/237086 |
| Acceso en línea: | https://revistas.usp.br/clinics/article/view/237086 |
| Access Level: | acceso abierto |
| Palabra clave: | Hepatitis c chronic Elasticity imaging techniques Liver Cirrhosis |
| Sumario: | Objectives: The primary objective was to evaluate Liver-Related Events (LREs), including hepatic decompensation (ascites, hemorrhagic varices and encephalopathy) and Hepatocellular Carcinoma (HCC), as well as changes in liver stiffness during the follow-up period among patients who achieved a Sustained Virological Response (SVR) after treatment for chronic Hepatitis C Virus (HCV) infection. Methods: A total of 218 patients with HCV were treated, and those who achieved an SVR were followed up for 3-years. Transient Elastography (TE) using FibroScan® was performed at various time points: before treatment, at the end of treatment, at 6-months post-treatment, at 1-year post-treatment, at 2-years post-treatment, and at 3-years post-treatment. Results: At 6-months post-treatment, a Liver Stiffness Measurement (LSM) cutoff of > 19 KPa was identified, leading to a 14.5-fold increase in the hazard of negative outcomes, including decompensation and/or HCC. The analysis of relative changes in liver stiffness between pre-treatment and 6-months posttreatment revealed that a reduction in LSM of -10% was associated with a -12% decrease in the hazard of decompensation and/or HCC, with this trend continuing as the LSM reduction reached -40%, resulting in a -41% hazard of decompensation and/or HCC. Conversely, an increase in the relative change during this period, such as an LSM increase of +10%, led to a + 14% increase in the hazard of decompensation. In cases where this relative change in LSM was +50%, the hazard of decompensation increased to +92. Conclusion: Transient elastography using FibroScan® can be a good tool for monitoring HCV patients with SVR after treatment to predict LREs in the long term. |
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