Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals

We aimed to investigate the early changes in liver and spleen stiffness measurement (LSM, SSM) in hepatitis C virus (HCV) patients with compensated advanced chronic liver disease (cACLD) treated with new antivirals (DAA) to elucidate factors determining the initial change in stiffness and its implic...

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Autores: Pons Delgado, Mònica|||0000-0002-0985-3320, Santos, Begoña, Simón Talero, Macarena|||0000-0002-1409-3936, Ventura-Cots, Meritxell|||0000-0001-9513-2855, Riveiro Barciela, Mar|||0000-0001-9309-2052, Esteban, Rafael|||0000-0001-5280-392X, Augustin Recio, Salvador|||0000-0002-3515-9033, Genescà Ferrer, Joan|||0000-0002-0831-8422
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:186314
Acceso en línea:https://ddd.uab.cat/record/186314
https://dx.doi.org/urn:doi:10.1177/1756283X17715198
Access Level:acceso abierto
Palabra clave:Compensated advanced chronic liver disease (cACLD)
Direct-acting antiviral agents (DAA)
Hepatitis C
Inflammation
Liver stiffness
Spleen stiffness
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spelling Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antiviralsPons Delgado, Mònica|||0000-0002-0985-3320Santos, BegoñaSimón Talero, Macarena|||0000-0002-1409-3936Ventura-Cots, Meritxell|||0000-0001-9513-2855Riveiro Barciela, Mar|||0000-0001-9309-2052Esteban, Rafael|||0000-0001-5280-392XAugustin Recio, Salvador|||0000-0002-3515-9033Genescà Ferrer, Joan|||0000-0002-0831-8422Compensated advanced chronic liver disease (cACLD)Direct-acting antiviral agents (DAA)Hepatitis CInflammationLiver stiffnessSpleen stiffnessWe aimed to investigate the early changes in liver and spleen stiffness measurement (LSM, SSM) in hepatitis C virus (HCV) patients with compensated advanced chronic liver disease (cACLD) treated with new antivirals (DAA) to elucidate factors determining the initial change in stiffness and its implications for the long-term follow up of HCV-cured patients. A total of 41 patients with cACLD who started DAA therapy underwent LSM and SSM at baseline, week 4, end of treatment (EOT), 24 and 48 weeks of follow up using transient elastography. LSM improved rapidly during the first 4 weeks of treatment (baseline: 20.8kPa; week 4: 17.5kPa, p = 0.002), with no significant changes between week 4 and EOT (18.3kPa, p = 0.444) and between EOT and 48-week follow up (14.3kPa, p = 0.148). Likewise, SSM improved rapidly (baseline: 45.7kPa; week 4: 33.8kPa, p = 0.047), with no significant changes between week 4 and EOT (30.8kPa, p = 0.153) and between EOT and 48-week follow up (31.2kPa, p = 0.317). A higher decrease in LSM was observed in patients with baseline ALT ⩾ twofold upper limit normal (2 × ULN) than in those with ALT < 2 × ULN (-5.7kPa versus -1.6kPa). Patients who presented a decrease in LSM ⩾ 10% during treatment compared with those with LSM < 10% decrease, showed lower SSM values, higher platelet counts and lower bilirubin levels at 24-week follow up. Those with decrease in SSM ⩾ 10%, presented a higher increase in platelets than those with SSM < 10% change (p = 0.015). LSM and SSM decrease very rapidly during DAA treatment in cACLD patients suggesting that it most probably reflects a reduction in inflammation rather than in fibrosis. cACLD patients should be maintained under surveillance independently of stiffness changes, because advanced fibrosis can still be present.Universitat Autònoma de Barcelona 22017-01-0120172017-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/186314https://dx.doi.org/urn:doi:10.1177/1756283X17715198reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI13-01289Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI14-00331Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI15-00066open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:1863142026-06-06T12:50:31Z
dc.title.none.fl_str_mv Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
title Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
spellingShingle Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
Pons Delgado, Mònica|||0000-0002-0985-3320
Compensated advanced chronic liver disease (cACLD)
Direct-acting antiviral agents (DAA)
Hepatitis C
Inflammation
Liver stiffness
Spleen stiffness
title_short Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
title_full Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
title_fullStr Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
title_full_unstemmed Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
title_sort Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals
dc.creator.none.fl_str_mv Pons Delgado, Mònica|||0000-0002-0985-3320
Santos, Begoña
Simón Talero, Macarena|||0000-0002-1409-3936
Ventura-Cots, Meritxell|||0000-0001-9513-2855
Riveiro Barciela, Mar|||0000-0001-9309-2052
Esteban, Rafael|||0000-0001-5280-392X
Augustin Recio, Salvador|||0000-0002-3515-9033
Genescà Ferrer, Joan|||0000-0002-0831-8422
author Pons Delgado, Mònica|||0000-0002-0985-3320
author_facet Pons Delgado, Mònica|||0000-0002-0985-3320
Santos, Begoña
Simón Talero, Macarena|||0000-0002-1409-3936
Ventura-Cots, Meritxell|||0000-0001-9513-2855
Riveiro Barciela, Mar|||0000-0001-9309-2052
Esteban, Rafael|||0000-0001-5280-392X
Augustin Recio, Salvador|||0000-0002-3515-9033
Genescà Ferrer, Joan|||0000-0002-0831-8422
author_role author
author2 Santos, Begoña
Simón Talero, Macarena|||0000-0002-1409-3936
Ventura-Cots, Meritxell|||0000-0001-9513-2855
Riveiro Barciela, Mar|||0000-0001-9309-2052
Esteban, Rafael|||0000-0001-5280-392X
Augustin Recio, Salvador|||0000-0002-3515-9033
Genescà Ferrer, Joan|||0000-0002-0831-8422
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Compensated advanced chronic liver disease (cACLD)
Direct-acting antiviral agents (DAA)
Hepatitis C
Inflammation
Liver stiffness
Spleen stiffness
topic Compensated advanced chronic liver disease (cACLD)
Direct-acting antiviral agents (DAA)
Hepatitis C
Inflammation
Liver stiffness
Spleen stiffness
description We aimed to investigate the early changes in liver and spleen stiffness measurement (LSM, SSM) in hepatitis C virus (HCV) patients with compensated advanced chronic liver disease (cACLD) treated with new antivirals (DAA) to elucidate factors determining the initial change in stiffness and its implications for the long-term follow up of HCV-cured patients. A total of 41 patients with cACLD who started DAA therapy underwent LSM and SSM at baseline, week 4, end of treatment (EOT), 24 and 48 weeks of follow up using transient elastography. LSM improved rapidly during the first 4 weeks of treatment (baseline: 20.8kPa; week 4: 17.5kPa, p = 0.002), with no significant changes between week 4 and EOT (18.3kPa, p = 0.444) and between EOT and 48-week follow up (14.3kPa, p = 0.148). Likewise, SSM improved rapidly (baseline: 45.7kPa; week 4: 33.8kPa, p = 0.047), with no significant changes between week 4 and EOT (30.8kPa, p = 0.153) and between EOT and 48-week follow up (31.2kPa, p = 0.317). A higher decrease in LSM was observed in patients with baseline ALT ⩾ twofold upper limit normal (2 × ULN) than in those with ALT < 2 × ULN (-5.7kPa versus -1.6kPa). Patients who presented a decrease in LSM ⩾ 10% during treatment compared with those with LSM < 10% decrease, showed lower SSM values, higher platelet counts and lower bilirubin levels at 24-week follow up. Those with decrease in SSM ⩾ 10%, presented a higher increase in platelets than those with SSM < 10% change (p = 0.015). LSM and SSM decrease very rapidly during DAA treatment in cACLD patients suggesting that it most probably reflects a reduction in inflammation rather than in fibrosis. cACLD patients should be maintained under surveillance independently of stiffness changes, because advanced fibrosis can still be present.
publishDate 2017
dc.date.none.fl_str_mv 2
2017-01-01
2017
2017-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/186314
https://dx.doi.org/urn:doi:10.1177/1756283X17715198
url https://ddd.uab.cat/record/186314
https://dx.doi.org/urn:doi:10.1177/1756283X17715198
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI13-01289
Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI14-00331
Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI15-00066
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300719

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