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Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis C patients

World Journal of Clinical Cases 2022年第17期10卷 5566-5576页

作者： Anya Mezina Arunkumar Krishnan Tinsay A Woreta Kevin B Rubenstein Eric watson Po-Hung Chen carla rodriguez-watson Department of Medicine Johns Hopkins School of MedicineBaltimoreMD 21287United States Division of Gastroenterology and Hepatology Johns Hopkins School of MedicineBaltimoreMD 21231United States Mid-Atlantic Permanente Research Institute Kaiser Permanente Mid-Atlantic StatesRockville 20852United States Department of Health Policy and Management Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMD 21287United States Innovation in Medical Evidence Development and Surveillance(IMEDS)Program Reagan-Udall Foundation for the FDAWashington20036United States

BACKGROUND Liver fibrosis is a common pathway of liver injury and is a feature of most chronic liver *** progression varies markedly in patients with hepatitis C virus(HCV).Liver stiffness has been recommended as a parameter of fibrosis progression/regression in patients with *** To investigate changes in liver stiffness measured by transient elastography(TE)in a large,racially diverse cohort of United States patients with chronic hepatitis C(CHC).METHODS We evaluated the differences in liver stiffness between patients treated with direct-acting antiviral(DAA)therapy and untreated *** had≥2 TE measurements and no prior DAA *** used linear regression to measure the change in liver stiffness between first and last TE in response to treatment,controlling for age,sex,race,diabetes,smoking status,human immunodeficiency virus status,baseline alanine aminotransferase,and baseline liver *** regression models analyzed the change in liver stiffness as measured by kPa,stratified by cirrhosis *** Of 813 patients,419(52%)initiated DAA *** liver stiffness was 12 kPa in 127(16%).Median time between first and last TE was 11.7 and 12.7 mo among treated and untreated patients,*** was no significant change in liver stiffness observed over time in either the group initiating DAA treatment(0.016 kPa/month;CI:-0.051,0.084)or in the untreated group(0.001 kPa/mo;CI:-0.090,0.092),controlling for covariates.A higher baseline kPa score was independently associated with decreased liver *** DAA treatment was not associated with a differential change in liver stiffness over time in patients with CHC compared to untreated patients.

关键词： Chronic hepatitis C Liver stiffness Cirrhosis Transient elastography Direct-acting antiviral therapy

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