Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes

Abstract The role of liver stiffness measurement (LSM) after sustained virological response (SVR) in HCV patients treated by direct-acting antivirals (DAAs) remains unclear. We aimed to evaluate LSM regression value after SVR and to identify risk factors associated with liver related complications (...

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Autores principales:	Juliana Piedade, Gustavo Pereira, Lívia Guimarães, Joana Duarte, Lívia Victor, Caroline Baldin, Cintia Inacio, Ricardo Santos, Úrsula Chaves, Estevão P. Nunes, Beatriz Grinsztejn, Valdilea G. Veloso, Flavia Fernandes, Hugo Perazzo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/015ddc539279451eaf447b3249abdbe7
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spelling	oai:doaj.org-article:015ddc539279451eaf447b3249abdbe72021-12-02T15:56:42ZLiver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes10.1038/s41598-021-91099-12045-2322https://doaj.org/article/015ddc539279451eaf447b3249abdbe72021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91099-1https://doaj.org/toc/2045-2322Abstract The role of liver stiffness measurement (LSM) after sustained virological response (SVR) in HCV patients treated by direct-acting antivirals (DAAs) remains unclear. We aimed to evaluate LSM regression value after SVR and to identify risk factors associated with liver related complications (LRC) or death. This retrospective study analyzed patients with LSM ≥ 10 kPa with LSM by transient elastography pre-DAAs and post-SVR. Patients with previous hepatic decompensation were excluded. Medical records were reviewed to identify primary outcomes. Kaplan–Meier curves and time-to-event Cox proportional-hazard models were performed. 456 patients [65% female, 62 years (IQR 57–68)] were included. During a follow-up of 2.3 years (IQR 1.6–2.7), 28 patients developed 37 outcomes [rate = 29.0 (95% CI 20.0–42.0) per 1000 person-years]. The cumulative incidence of outcomes was significantly lower in patients who regressed LSM ≥ 20% [3.4% (95% CI 1.8–7.0) vs. 9.0% (5.5–14.5), p = 0.028]. In a multivariate Cox-model [HR(95% CI)], male gender [HR = 3.00 (1.30–6.95), p = 0.010], baseline albumin < 3.5 mg/dL [HR = 4.49 (1.95–10.34), p < 0.001] and baseline unfavorable Baveno-VI [HR = 4.72 (1.32–16.83), p = 0.017] were independently associated and LSM regression ≥ 20% after SVR had a trend to reduce the risk of LRC or death [HR = 0.45 (0.21–1.02), p = 0.058]. The use of simple parameters before DAAs and repetition of LSM post-SVR can identify patients with different risks for severe outcome after HCV eradication.Juliana PiedadeGustavo PereiraLívia GuimarãesJoana DuarteLívia VictorCaroline BaldinCintia InacioRicardo SantosÚrsula ChavesEstevão P. NunesBeatriz GrinsztejnValdilea G. VelosoFlavia FernandesHugo PerazzoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juliana Piedade Gustavo Pereira Lívia Guimarães Joana Duarte Lívia Victor Caroline Baldin Cintia Inacio Ricardo Santos Úrsula Chaves Estevão P. Nunes Beatriz Grinsztejn Valdilea G. Veloso Flavia Fernandes Hugo Perazzo Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
description	Abstract The role of liver stiffness measurement (LSM) after sustained virological response (SVR) in HCV patients treated by direct-acting antivirals (DAAs) remains unclear. We aimed to evaluate LSM regression value after SVR and to identify risk factors associated with liver related complications (LRC) or death. This retrospective study analyzed patients with LSM ≥ 10 kPa with LSM by transient elastography pre-DAAs and post-SVR. Patients with previous hepatic decompensation were excluded. Medical records were reviewed to identify primary outcomes. Kaplan–Meier curves and time-to-event Cox proportional-hazard models were performed. 456 patients [65% female, 62 years (IQR 57–68)] were included. During a follow-up of 2.3 years (IQR 1.6–2.7), 28 patients developed 37 outcomes [rate = 29.0 (95% CI 20.0–42.0) per 1000 person-years]. The cumulative incidence of outcomes was significantly lower in patients who regressed LSM ≥ 20% [3.4% (95% CI 1.8–7.0) vs. 9.0% (5.5–14.5), p = 0.028]. In a multivariate Cox-model [HR(95% CI)], male gender [HR = 3.00 (1.30–6.95), p = 0.010], baseline albumin < 3.5 mg/dL [HR = 4.49 (1.95–10.34), p < 0.001] and baseline unfavorable Baveno-VI [HR = 4.72 (1.32–16.83), p = 0.017] were independently associated and LSM regression ≥ 20% after SVR had a trend to reduce the risk of LRC or death [HR = 0.45 (0.21–1.02), p = 0.058]. The use of simple parameters before DAAs and repetition of LSM post-SVR can identify patients with different risks for severe outcome after HCV eradication.
format	article
author	Juliana Piedade Gustavo Pereira Lívia Guimarães Joana Duarte Lívia Victor Caroline Baldin Cintia Inacio Ricardo Santos Úrsula Chaves Estevão P. Nunes Beatriz Grinsztejn Valdilea G. Veloso Flavia Fernandes Hugo Perazzo
author_facet	Juliana Piedade Gustavo Pereira Lívia Guimarães Joana Duarte Lívia Victor Caroline Baldin Cintia Inacio Ricardo Santos Úrsula Chaves Estevão P. Nunes Beatriz Grinsztejn Valdilea G. Veloso Flavia Fernandes Hugo Perazzo
author_sort	Juliana Piedade
title	Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
title_short	Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
title_full	Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
title_fullStr	Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
title_full_unstemmed	Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
title_sort	liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/015ddc539279451eaf447b3249abdbe7
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Liver stiffness regression after sustained virological response by direct-acting antivirals reduces the risk of outcomes

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