Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study
Long‐term effects on cirrhosis and portal hypertension of direct antiviral agent (DAA)‐based eradication of hepatitis C virus (HCV) are still under debate. We analysed dynamics of liver and spleen elastography to assess potential regression of cirrhosis and portal hypertension 3 years post‐treatment...
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| Veröffentlicht in: | Journal of viral hepatitis 2021-11, Vol.28 (11), p.1604-1613 |
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| creator | Knop, Viola Hoppe, Daniel Vermehren, Johannes Troetschler, Sven Herrmann, Eva Vermehren, Annika Friedrich‐Rust, Mireen Sarrazin, Christoph Trebicka, Jonel Zeuzem, Stefan Welker, Martin‐Walter |
| description | Long‐term effects on cirrhosis and portal hypertension of direct antiviral agent (DAA)‐based eradication of hepatitis C virus (HCV) are still under debate. We analysed dynamics of liver and spleen elastography to assess potential regression of cirrhosis and portal hypertension 3 years post‐treatment. Fifty‐four patients with HCV‐associated cirrhosis and DAA‐induced SVR were included. Liver and spleen stiffness were measured at baseline (BL), end of treatment (EOT), 24 weeks after EOT (FU24) and 1, 2 and 3 (FU144) years post‐treatment by transient liver elastography (L‐TE) and point shear wave elastography (pSWE) using acoustic radiation force impulse (ARFI) of the liver (L‐ARFI) and spleen (S‐ARFI). Biochemical, virological and clinical data were also obtained. Liver stiffness assessed by L‐TE decreased between BL [median (range), 32.5(9.1–75) kPa] and EOT [21.3(6.7–73.5) kPa; p |
| doi_str_mv | 10.1111/jvh.13587 |
| format | Article |
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We analysed dynamics of liver and spleen elastography to assess potential regression of cirrhosis and portal hypertension 3 years post‐treatment. Fifty‐four patients with HCV‐associated cirrhosis and DAA‐induced SVR were included. Liver and spleen stiffness were measured at baseline (BL), end of treatment (EOT), 24 weeks after EOT (FU24) and 1, 2 and 3 (FU144) years post‐treatment by transient liver elastography (L‐TE) and point shear wave elastography (pSWE) using acoustic radiation force impulse (ARFI) of the liver (L‐ARFI) and spleen (S‐ARFI). Biochemical, virological and clinical data were also obtained. Liver stiffness assessed by L‐TE decreased between BL [median (range), 32.5(9.1–75) kPa] and EOT [21.3(6.7–73.5) kPa; p < .0001] and EOT and FU144 [16(4.1–75) kPa; p = .006]. L‐ARFI values improved between EOT [2.5(1.2–4.1) m/s] and FU144 [1.7(0.9–4.1) m/s; p = .001], while spleen stiffness remained unchanged. Overall, L‐TE improved in 38 of 54 (70.4%) patients at EOT and 29 of 38 (76.3%) declined further until FU144, whereas L‐ARFI values decreased in 30/54 (55.6%) patients at EOT and continued to decrease in 28/30 (93.3%) patients at FU144. Low bilirubin and high albumin levels at BL were associated with improved L‐ARFI values (p = .048) at EOT or regression of cirrhosis (<12.5 kPa) by L‐TE at FU144 (p = .005), respectively. Liver stiffness, but not spleen stiffness, continued to decline in a considerable proportion of patients with advanced liver disease after HCV eradication.</description><identifier>ISSN: 1352-0504</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.13587</identifier><identifier>PMID: 34342081</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>acoustic radiation force impulse ; Antiviral Agents - therapeutic use ; Bilirubin ; chronic hepatitis C ; Cirrhosis ; direct‐acting antiviral (DAA) treatment ; Elasticity Imaging Techniques ; Fibrosis ; Follow-Up Studies ; Hepatitis C ; Hepatitis C - drug therapy ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - drug therapy ; Hepatitis C, Chronic - pathology ; Humans ; Hypertension ; Hypertension, Portal - drug therapy ; Hypertension, Portal - pathology ; Liver - diagnostic imaging ; Liver - pathology ; Liver cirrhosis ; Liver Cirrhosis - drug therapy ; Liver diseases ; Longitudinal Studies ; Patients ; portal hypertension ; Prospective Studies ; Spleen ; Sustained Virologic Response ; transient elastography ; Treatment Outcome</subject><ispartof>Journal of viral hepatitis, 2021-11, Vol.28 (11), p.1604-1613</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2021 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3887-c4344dd8659db29238f0e8b9d96252dab08ab565ff639a588133d8fa916682b93</citedby><cites>FETCH-LOGICAL-c3887-c4344dd8659db29238f0e8b9d96252dab08ab565ff639a588133d8fa916682b93</cites><orcidid>0000-0002-7434-5218</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.13587$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.13587$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34342081$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knop, Viola</creatorcontrib><creatorcontrib>Hoppe, Daniel</creatorcontrib><creatorcontrib>Vermehren, Johannes</creatorcontrib><creatorcontrib>Troetschler, Sven</creatorcontrib><creatorcontrib>Herrmann, Eva</creatorcontrib><creatorcontrib>Vermehren, Annika</creatorcontrib><creatorcontrib>Friedrich‐Rust, Mireen</creatorcontrib><creatorcontrib>Sarrazin, Christoph</creatorcontrib><creatorcontrib>Trebicka, Jonel</creatorcontrib><creatorcontrib>Zeuzem, Stefan</creatorcontrib><creatorcontrib>Welker, Martin‐Walter</creatorcontrib><title>Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>Long‐term effects on cirrhosis and portal hypertension of direct antiviral agent (DAA)‐based eradication of hepatitis C virus (HCV) are still under debate. We analysed dynamics of liver and spleen elastography to assess potential regression of cirrhosis and portal hypertension 3 years post‐treatment. Fifty‐four patients with HCV‐associated cirrhosis and DAA‐induced SVR were included. Liver and spleen stiffness were measured at baseline (BL), end of treatment (EOT), 24 weeks after EOT (FU24) and 1, 2 and 3 (FU144) years post‐treatment by transient liver elastography (L‐TE) and point shear wave elastography (pSWE) using acoustic radiation force impulse (ARFI) of the liver (L‐ARFI) and spleen (S‐ARFI). Biochemical, virological and clinical data were also obtained. Liver stiffness assessed by L‐TE decreased between BL [median (range), 32.5(9.1–75) kPa] and EOT [21.3(6.7–73.5) kPa; p < .0001] and EOT and FU144 [16(4.1–75) kPa; p = .006]. L‐ARFI values improved between EOT [2.5(1.2–4.1) m/s] and FU144 [1.7(0.9–4.1) m/s; p = .001], while spleen stiffness remained unchanged. Overall, L‐TE improved in 38 of 54 (70.4%) patients at EOT and 29 of 38 (76.3%) declined further until FU144, whereas L‐ARFI values decreased in 30/54 (55.6%) patients at EOT and continued to decrease in 28/30 (93.3%) patients at FU144. Low bilirubin and high albumin levels at BL were associated with improved L‐ARFI values (p = .048) at EOT or regression of cirrhosis (<12.5 kPa) by L‐TE at FU144 (p = .005), respectively. Liver stiffness, but not spleen stiffness, continued to decline in a considerable proportion of patients with advanced liver disease after HCV eradication.</description><subject>acoustic radiation force impulse</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Bilirubin</subject><subject>chronic hepatitis C</subject><subject>Cirrhosis</subject><subject>direct‐acting antiviral (DAA) treatment</subject><subject>Elasticity Imaging Techniques</subject><subject>Fibrosis</subject><subject>Follow-Up Studies</subject><subject>Hepatitis C</subject><subject>Hepatitis C - drug therapy</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Hepatitis C, Chronic - pathology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension, Portal - drug therapy</subject><subject>Hypertension, Portal - pathology</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - pathology</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - drug therapy</subject><subject>Liver diseases</subject><subject>Longitudinal Studies</subject><subject>Patients</subject><subject>portal hypertension</subject><subject>Prospective Studies</subject><subject>Spleen</subject><subject>Sustained Virologic Response</subject><subject>transient elastography</subject><subject>Treatment Outcome</subject><issn>1352-0504</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1ks-O0zAQxiMEYpeFAy-ALHFpD9lN7Dh1uKEKKGgFEn96jZzYaVyldtbjpMqNR-AZeQ8kJu3CAQlfPBr__M039kTR8zS5TnHd7Mf2OmVcrB5ElynLeUxFwR7OMadxwpPsInoCsE-SlFGePo4uWMYymoj0Mvr10dmf338YO0owoyYSQAMctA3ENaQxlXdggHi985g3zhJpFemdD7Ij7dRrH7Q95Y0lvQwGbwI5mtASqUZpa61I3XpnTU1aPQMB5dZkNH4Astist0ssj1VdbWRAuEMXnigDWoI-FYMBgjQWz_CS69wOpdBM7ywCiy_bz8tXhJFJSw-kcV3njqg49LN_SXr03-s6zL11zu5MGJSx6B0wmJ5GjxrZgX52v19F396--brexLef3r1fv76NaybEKq7xuTKlRM4LVdGCMtEkWlSFKnLKqZJVImTFc940OSskFyJlTIlGFmmeC1oV7CpanHXRzt2gIZQHA7XuOmm1G6CknK84fkm-QvTlP-jeDR4dz5SgGWOC50gtz1SN_YHXTdl7c5B-KtOknGeixJkoTzOB7It7xaE6aPWX_DMECNycgaPp9PR_pfLDdnOW_A1Naslj</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Knop, Viola</creator><creator>Hoppe, Daniel</creator><creator>Vermehren, Johannes</creator><creator>Troetschler, Sven</creator><creator>Herrmann, Eva</creator><creator>Vermehren, Annika</creator><creator>Friedrich‐Rust, Mireen</creator><creator>Sarrazin, Christoph</creator><creator>Trebicka, Jonel</creator><creator>Zeuzem, Stefan</creator><creator>Welker, Martin‐Walter</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7434-5218</orcidid></search><sort><creationdate>202111</creationdate><title>Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study</title><author>Knop, Viola ; Hoppe, Daniel ; Vermehren, Johannes ; Troetschler, Sven ; Herrmann, Eva ; Vermehren, Annika ; Friedrich‐Rust, Mireen ; Sarrazin, Christoph ; Trebicka, Jonel ; Zeuzem, Stefan ; Welker, Martin‐Walter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3887-c4344dd8659db29238f0e8b9d96252dab08ab565ff639a588133d8fa916682b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>acoustic radiation force impulse</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Bilirubin</topic><topic>chronic hepatitis C</topic><topic>Cirrhosis</topic><topic>direct‐acting antiviral (DAA) treatment</topic><topic>Elasticity Imaging Techniques</topic><topic>Fibrosis</topic><topic>Follow-Up Studies</topic><topic>Hepatitis C</topic><topic>Hepatitis C - drug therapy</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - drug therapy</topic><topic>Hepatitis C, Chronic - pathology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension, Portal - drug therapy</topic><topic>Hypertension, Portal - pathology</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - pathology</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - drug therapy</topic><topic>Liver diseases</topic><topic>Longitudinal Studies</topic><topic>Patients</topic><topic>portal hypertension</topic><topic>Prospective Studies</topic><topic>Spleen</topic><topic>Sustained Virologic Response</topic><topic>transient elastography</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knop, Viola</creatorcontrib><creatorcontrib>Hoppe, Daniel</creatorcontrib><creatorcontrib>Vermehren, Johannes</creatorcontrib><creatorcontrib>Troetschler, Sven</creatorcontrib><creatorcontrib>Herrmann, Eva</creatorcontrib><creatorcontrib>Vermehren, Annika</creatorcontrib><creatorcontrib>Friedrich‐Rust, Mireen</creatorcontrib><creatorcontrib>Sarrazin, Christoph</creatorcontrib><creatorcontrib>Trebicka, Jonel</creatorcontrib><creatorcontrib>Zeuzem, Stefan</creatorcontrib><creatorcontrib>Welker, Martin‐Walter</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of viral hepatitis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knop, Viola</au><au>Hoppe, Daniel</au><au>Vermehren, Johannes</au><au>Troetschler, Sven</au><au>Herrmann, Eva</au><au>Vermehren, Annika</au><au>Friedrich‐Rust, Mireen</au><au>Sarrazin, Christoph</au><au>Trebicka, Jonel</au><au>Zeuzem, Stefan</au><au>Welker, Martin‐Walter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study</atitle><jtitle>Journal of viral hepatitis</jtitle><addtitle>J Viral Hepat</addtitle><date>2021-11</date><risdate>2021</risdate><volume>28</volume><issue>11</issue><spage>1604</spage><epage>1613</epage><pages>1604-1613</pages><issn>1352-0504</issn><eissn>1365-2893</eissn><abstract>Long‐term effects on cirrhosis and portal hypertension of direct antiviral agent (DAA)‐based eradication of hepatitis C virus (HCV) are still under debate. We analysed dynamics of liver and spleen elastography to assess potential regression of cirrhosis and portal hypertension 3 years post‐treatment. Fifty‐four patients with HCV‐associated cirrhosis and DAA‐induced SVR were included. Liver and spleen stiffness were measured at baseline (BL), end of treatment (EOT), 24 weeks after EOT (FU24) and 1, 2 and 3 (FU144) years post‐treatment by transient liver elastography (L‐TE) and point shear wave elastography (pSWE) using acoustic radiation force impulse (ARFI) of the liver (L‐ARFI) and spleen (S‐ARFI). Biochemical, virological and clinical data were also obtained. Liver stiffness assessed by L‐TE decreased between BL [median (range), 32.5(9.1–75) kPa] and EOT [21.3(6.7–73.5) kPa; p < .0001] and EOT and FU144 [16(4.1–75) kPa; p = .006]. L‐ARFI values improved between EOT [2.5(1.2–4.1) m/s] and FU144 [1.7(0.9–4.1) m/s; p = .001], while spleen stiffness remained unchanged. Overall, L‐TE improved in 38 of 54 (70.4%) patients at EOT and 29 of 38 (76.3%) declined further until FU144, whereas L‐ARFI values decreased in 30/54 (55.6%) patients at EOT and continued to decrease in 28/30 (93.3%) patients at FU144. Low bilirubin and high albumin levels at BL were associated with improved L‐ARFI values (p = .048) at EOT or regression of cirrhosis (<12.5 kPa) by L‐TE at FU144 (p = .005), respectively. Liver stiffness, but not spleen stiffness, continued to decline in a considerable proportion of patients with advanced liver disease after HCV eradication.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34342081</pmid><doi>10.1111/jvh.13587</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-7434-5218</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | acoustic radiation force impulse Antiviral Agents - therapeutic use Bilirubin chronic hepatitis C Cirrhosis direct‐acting antiviral (DAA) treatment Elasticity Imaging Techniques Fibrosis Follow-Up Studies Hepatitis C Hepatitis C - drug therapy Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy Hepatitis C, Chronic - pathology Humans Hypertension Hypertension, Portal - drug therapy Hypertension, Portal - pathology Liver - diagnostic imaging Liver - pathology Liver cirrhosis Liver Cirrhosis - drug therapy Liver diseases Longitudinal Studies Patients portal hypertension Prospective Studies Spleen Sustained Virologic Response transient elastography Treatment Outcome |
| title | Non‐invasive assessment of fibrosis regression and portal hypertension in patients with advanced chronic hepatitis C virus (HCV)‐associated liver disease and sustained virologic response (SVR): 3 years follow‐up of a prospective longitudinal study |
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