Abstract

BackgroundTo compare on-treatment and off-treatment parameters acquired using acoustic radiation force impulse elastography, the Fibrosis-4 (FIB-4) index, and aspartate aminotransferase-to-platelet ratio index (APRI) in patients with chronic hepatitis C (CHC).MethodsPatients received therapies based on pegylated interferon or direct-acting antiviral agents. The changes in paired patient parameters, including liver stiffness (LS) values, the FIB-4 index, and APRI, from baseline to sustained virologic response (SVR) visit (24 weeks after the end of treatment) were compared. Multiple regression models were used to identify significant factors that explained the correlations with LS, FIB-4, and APRI values and SVR.ResultsA total of 256 patients were included, of which 219 (85.5%) achieved SVR. The paired LS values declined significantly from baseline to SVR visit in all groups and subgroups except the nonresponder subgroup (n = 10). Body mass index (P = 0.0062) and baseline LS (P < 0.0001) were identified as independent factors that explained the LS declines. Likewise, the baseline FIB-4 (P < 0.0001) and APRI (P < 0.0001) values independently explained the declines in the FIB-4 index and APRI, respectively. Moreover, interleukin-28B polymorphisms, baseline LS, and rapid virologic response were identified as independent correlates with SVR.ConclusionsPaired LS measurements in patients treated for CHC exhibited significant declines comparable to those in FIB-4 and APRI values. These declines may have correlated with the resolution of necroinflammation. Baseline LS values predicted SVR.

Highlights

  • Chronic hepatitis C (CHC) is a major global healthcare challenge [1]

  • The paired liver stiffness (LS) values declined significantly from baseline to sustained virologic response (SVR) visit in all groups and subgroups except the nonresponder subgroup (n = 10)

  • The baseline FIB-4 (P < 0.0001) and aminotransferaseto-platelet ratio index (APRI) (P < 0.0001) values independently explained the declines in the FIB-4 index and APRI, respectively

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Summary

Introduction

Chronic hepatitis C (CHC) is a major global healthcare challenge [1]. Maintaining a sustained virologic response (SVR) after treatment is the most crucial goal of treatment for CHC. Patients with steady and prolonged virus-clearance states after SVR subsequently develop fewer adverse endpoints such as cirrhosis, decompensation, and hepatocellular carcinoma (HCC) than do those without SVR [2]. SVR does not guarantee the prevention of such adverse liver-related endpoints. Post-SVR care requires programmed surveillance [3]. Before predicting post-SVR endpoints, parameters over the treatment course prior to the occurrence of SVR should be investigated to obtain more insights into CHC. To compare on-treatment and off-treatment parameters acquired using acoustic radiation force impulse elastography, the Fibrosis-4 (FIB-4) index, and aspartate aminotransferaseto-platelet ratio index (APRI) in patients with chronic hepatitis C (CHC)

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