scholarly journals One-Year Outcomes after Ledipasvir/Sofosbuvir Treatment of Chronic Hepatitis C in Teenagers with and without Significant Liver Fibrosis—A Case Series Report

Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1518
Author(s):  
Maria Pokorska-Śpiewak ◽  
Anna Dobrzeniecka ◽  
Magdalena Marczyńska
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Case Series ◽  
Significant Fibrosis ◽  
End Of Treatment ◽  
One Year ◽  
Significant Liver Fibrosis

One-year outcomes after therapy with ledipasvir/sofosbuvir (LDV/SOF) in children with chronic hepatitis C (CHC) presenting with and without significant liver fibrosis were analyzed. We included patients aged 12–17 years treated with LDV/SOF, presenting with significant fibrosis (F ≥ 2 on the METAVIR scale) in transient elastography (TE) at the baseline and we compared the outcomes with that of patients without fibrosis. Patients were followed every 4 weeks during the treatment, at the end of the therapy, at week 12 posttreatment, and one year after the end of treatment. Liver fibrosis was established using noninvasive methods: TE, aspartate transaminase-to-platelet ratio index (APRI), and Fibrosis-4 index (FIB-4). There were four patients with significant fibrosis at baseline: one with a fibrosis score of F2 on the METAVIR scale, and three with cirrhosis (F4) at baseline. One year after the end of treatment, the hepatitis C viral load was undetectable in three of them. One patient was lost to follow-up after week 4. In two out of the four patients, a significant improvement and regression of liver fibrosis was observed (from stage F4 and F2 to F0-F1 on the METAVIR scale). In one patient, the liver stiffness measurement median increased 12 weeks after the end of the treatment and then decreased, but still correlated with stage F4. An improvement in the APRI was observed in all patients. In four patients without fibrosis, the treatment was effective and no progression of fibrosis was observed. A one-year observation of teenagers with CHC and significant fibrosis treated with LDV/SOF revealed that regression of liver fibrosis is possible, but not certain. Further observations in larger groups of patients are necessary to find predictors of liver fibrosis regression.

Long-term Outcomes of Ledipasvir/sofosbuvir Treatment of Chronic Hepatitis C in Four Teenagers With Significant Liver Fibrosis

2021 ◽  
Author(s):  
Maria Pokorska-Śpiewak ◽  
Anna Dobrzeniecka ◽  
Magdalena Marczyńska
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Long Term Outcomes ◽  
Significant Fibrosis ◽  
End Of Treatment ◽  
One Year ◽  
Significant Liver Fibrosis

Abstract Long-term outcomes of therapy with ledipasvir/sofosbuvir (LDV/SOF) in children with chronic hepatitis C (CHC) and significant liver fibrosis were evaluated. Among 35 patients aged 12-17 years treated with LDV/SOF, there were four participants with significant fibrosis: one with a fibrosis score of F2 in the METAVIR scale, and three with cirrhosis (F4) evaluated with transient elastography (TE) at baseline. Patients were followed every 4 weeks during the treatment, at the end of the therapy, week 12 posttreatment, and one year after the end of treatment. One year after the end of treatment, the hepatitis C viral load was undetectable in three patients. In 2/4 patients, a significant regression of liver fibrosis was observed (from stage F4 and F2 to F0-F1 in the METAVIR scale). In one patient, the liver stiffness measurement median increased 12 weeks after the end of the treatment and then decreased but still correlated with stage F4. One patient was lost to follow-up after week 4. A one-year observation of teenagers with CHC and significant fibrosis treated with LDV/SOF revealed that regression of liver fibrosis is possible, but not obligatory. Further observations in larger groups of patients are necessary to find predictors of liver fibrosis regression.

Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

2016 ◽  
Vol 25 (3) ◽  
pp. 331-335 ◽  
Author(s):  
Giovanna Ferraioli ◽  
Laura Maiocchi ◽  
Raffaella Lissandrin ◽  
Carmine Tinelli ◽  
Annalisa De Silvestri ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Real Life ◽  
Advanced Fibrosis ◽  
Liver Stiffness Measurement ◽  
Significant Fibrosis ◽  
Stiffness Measurement

Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance. Abbreviations: ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; AUROC: area under the ROC curve; BMI: body mass index; GGT: gamma-glutamyl transferase; LR: likelihood ratio; LSM: liver stiffness measurement; pSWE: point shear wave elastography; ROC: receiver operating characteristic; VCTE: vibration controlled transient elastography; VTQ®: virtual touch quantification.

scholarly journals Assessment of Liver Stiffness Regression and Hepatocellular Carcinoma Risk in Chronic Hepatitis C Patients after Treatment with Direct-Acting Antiviral Drugs

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 210
Author(s):  
Martynas Ridziauskas ◽  
Birutė Zablockienė ◽  
Ligita Jančorienė ◽  
Artūras Samuilis ◽  
Rolandas Zablockis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Direct Acting Antiviral ◽  
End Of Treatment ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Direct Acting

Background and Objectives: Chronic hepatitis C virus infection affects about 71 million people worldwide. It is one of the most common chronic liver conditions associated with an increased risk of developing liver cirrhosis and cancer. The aim of this study was to evaluate changes in liver fibrosis and the risk of developing hepatocellular carcinoma after direct-acting antiviral drug therapy, and to assess factors, linked with these outcomes. Materials and Methods: 70 chronic hepatitis C patients were evaluated for factors linked to increased risk of de novo liver cancer and ≥ 20% decrease of ultrasound transient elastography values 12 weeks after the end of treatment. Results: The primary outcome was an improvement of liver stiffness at the end of treatment (p = 0.004), except for patients with diabetes mellitus type 2 (p = 0.49). Logistic regression analysis revealed factors associated with ≥ 20% decrease of liver stiffness values: lower degree of steatosis in liver tissue biopsy (p = 0.053); no history of interferon-based therapy (p = 0.045); elevated liver enzymes (p = 0.023–0.036); higher baseline liver stiffness value (p = 0.045) and absence of splenomegaly (p = 0.035). Hepatocellular carcinoma developed in 4 (5.7%) patients, all with high alpha-fetoprotein values (p = 0.0043) and hypoechoic liver mass (p = 0.0001), three of these patients had diabetes mellitus type 2. Conclusions: Liver stiffness decrease was significant as early as 12 weeks after the end of treatment. Patients with diabetes and advanced liver disease are at higher risk of developing non-regressive fibrosis and hepatocellular carcinoma even after successful treatment.

scholarly journals Liver stiffness in chronic hepatitis C virus infection

2019 ◽  
Vol 57 (2) ◽  
pp. 85-98
Author(s):  
Romeo-Gabriel Mihăilă
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Stiffness Measurement ◽  
A Value

Abstract Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.

scholarly journals Real-world single-center experience with direct-acting antivirals for improvement of the liver fibrosis after chronic hepatitis C treatment

2020 ◽  
Vol 28 ◽  
pp. 204020662097483
Author(s):  
Sun Hee Lee ◽  
Hyun Phil Shin ◽  
Joung Il Lee
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Serum Biomarkers ◽  
Post Treatment ◽  
Direct Acting Antivirals ◽  
Number Of Patients ◽  
Direct Acting

Background Recently, new direct-acting antivirals (DAAs) are known to eradicate chronic hepatitis C (CHC) virus infection and prevent the progression of liver fibrosis. Liver fibrosis may predispose to liver cirrhosis or hepatocellular carcinoma. We investigated the effect of DAAs on liver fibrosis using non-invasive methods, and evaluated the correlations of these methods. Methods We retrospectively analyzed 68 patients with CHC who were treated with DAAs and reached sustained virologic response at 12 weeks post-treatment from January 2016 to October 2018. The degree of liver fibrosis was assessed using serum biomarkers, such as AST-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) index. Liver stiffness was assessed using two-dimensional shear-wave elastography (2 D-SWE). The pre- and post-treatment serum biomarker levels and SWE findings were evaluated and compared. Results A total of 68 patients with CHC were enrolled. The median age was 58 years (52.3–73 years) and 37 patients (54.4%) were female. After treatment, the median APRI was decreased from 0.701 to 0.328 (P < 0.0001), and the median FIB-4 was decreased from 2.355 to 1.860 (P < 0.0001). The median kPa in 2 D-SWE significantly reduced from 6.85 to 5.66 (P = 0.013). APRI and FIB-4 were significantly correlated pre- and post-treatment; however, the correlation between the serum biomarkers and 2 D-SWE was partially significant. Conclusion The serum fibrosis biomarkers and liver stiffness on 2 D-SWE were shown to be improved after the treatment with DAAs. Further research including larger number of patients is needed to compare the efficacy of each evaluating method.

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