Background: Direct acting antivirals(DAAs) are effective in reducing inflammatory ant fibrotic markers in patients with chronic hepatitis C virus(HCV) infection and to prevent liver-related complications. Two-dimensional shear wave elastography(2D-SWE) is an effective technique for the assessment of liver fibrosis. Aim: To evaluate changes in liver stiffness(LS) in HCV cirrhotic patients undergoing DAA therapy and to identify non-invasive parameters that predict the occurrence of liver-related events. Methods: We enrolled 229 patients who received DAAs between January 2015 and October 2018. Ultrasound parameters and laboratory data were assessed before treatment and 24(T1) and 48(T2) weeks after end of treatment. Patients were followed up every 6 months to evaluate the development of HCC and other liver related complications. Multiple Cox regression analysis was used to determine parameters associated with the development of complications. Results: Model for End-stage Liver Disease(MELD) score(HR 1.16; CI 95% 1.01-1.33; p = 0.026) and a change in LS at T2(1-year Delta LS) < 20%(HR 2.98; CI 95% 1.01-8.1; p = 0.03) were independently associated with HCC risk. One-year Delta-LS <20% was independently associated with the development of ascites(HR 5.08; CI 95% 1.03 - 25.14; p = 0.04). Conclusions: Dynamic changes of 2D-SWE-measured LS after DAA therapy may be a useful tool to identify patients who are at higher risk of liver related complications.

Nicoletti, A., Ainora, M. E., Cintoni, M., Garcovich, M., Funaro, B., Pecere, S., De Siena, M., Santopaolo, F., Ponziani, F. R., Riccardi, L., Grieco, A., Pompili, M., Gasbarrini, A., Zocco, M. A., Dynamics of liver stiffness predicts complications in patients with HCV related cirrhosis treated with direct-acting antivirals, <<DIGESTIVE AND LIVER DISEASE>>, N/A; (N/A): N/A-N/A. [doi:10.1016/j.dld.2023.04.018] [https://hdl.handle.net/10807/240215]

Dynamics of liver stiffness predicts complications in patients with HCV related cirrhosis treated with direct-acting antivirals

Nicoletti, Alberto;Ainora, Maria Elena;Cintoni, Marco;Garcovich, Matteo;Pecere, Silvia;De Siena, Martina;Santopaolo, Francesco;Ponziani, Francesca Romana;Riccardi, Laura;Grieco, Antonio;Pompili, Maurizio;Gasbarrini, Antonio;Zocco, Maria Assunta
2023

Abstract

Background: Direct acting antivirals(DAAs) are effective in reducing inflammatory ant fibrotic markers in patients with chronic hepatitis C virus(HCV) infection and to prevent liver-related complications. Two-dimensional shear wave elastography(2D-SWE) is an effective technique for the assessment of liver fibrosis. Aim: To evaluate changes in liver stiffness(LS) in HCV cirrhotic patients undergoing DAA therapy and to identify non-invasive parameters that predict the occurrence of liver-related events. Methods: We enrolled 229 patients who received DAAs between January 2015 and October 2018. Ultrasound parameters and laboratory data were assessed before treatment and 24(T1) and 48(T2) weeks after end of treatment. Patients were followed up every 6 months to evaluate the development of HCC and other liver related complications. Multiple Cox regression analysis was used to determine parameters associated with the development of complications. Results: Model for End-stage Liver Disease(MELD) score(HR 1.16; CI 95% 1.01-1.33; p = 0.026) and a change in LS at T2(1-year Delta LS) < 20%(HR 2.98; CI 95% 1.01-8.1; p = 0.03) were independently associated with HCC risk. One-year Delta-LS <20% was independently associated with the development of ascites(HR 5.08; CI 95% 1.03 - 25.14; p = 0.04). Conclusions: Dynamic changes of 2D-SWE-measured LS after DAA therapy may be a useful tool to identify patients who are at higher risk of liver related complications.
2023
Inglese
Nicoletti, A., Ainora, M. E., Cintoni, M., Garcovich, M., Funaro, B., Pecere, S., De Siena, M., Santopaolo, F., Ponziani, F. R., Riccardi, L., Grieco, A., Pompili, M., Gasbarrini, A., Zocco, M. A., Dynamics of liver stiffness predicts complications in patients with HCV related cirrhosis treated with direct-acting antivirals, <<DIGESTIVE AND LIVER DISEASE>>, N/A; (N/A): N/A-N/A. [doi:10.1016/j.dld.2023.04.018] [https://hdl.handle.net/10807/240215]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/240215
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