ABSTRACT
Objectives: To assess the role of baseline liver stiffness (LS) by Transient elastography (TE) and FIB-4 in the prediction of virological response to sofosbuvir - based regimens in chronic HCV patients.Methods: A retrospective, multicenter study including 7256 chronic HCV patients who received different sofosbuvir-based regimens. Baseline demographic and laboratory data were recorded. TE was performed with FIB-4 calculation at baseline.Results: Sustained virological response at week 12 post-treatment (SVR12) was 91.4%. Pretreatment TE values and FIB-4 were significantly lower among sustained responders (17.8 ± 11.5 kPa, 2.66 ± 1.98, respectively) versus relapsers (24.5 ± 13.9 kPa, 4.02 ± 3.3, respectively). Best cutoff levels for LS by TE and FIB-4 score for prediction of failure to treatment response were 16.7 kPa and 2.4, respectively. Among different treatment protocol, patients with FIB-4 > 2.4, TE values >16.7 kPa are more prone to treatment failure except when using SOF/SIM treatment regimens.Conclusion: Baseline LS by TE and FIB-4 score may be useful for predicting treatment outcome in the new era of DAAs and could be integrated into pretreatment assessment of chronic HCV patients for better optimization of patient management.
Subject(s)
Antiviral Agents/therapeutic use , Clinical Enzyme Tests , Elasticity Imaging Techniques , Hepatitis C, Chronic/drug therapy , Liver Cirrhosis/drug therapy , Liver/drug effects , Sofosbuvir/therapeutic use , Adolescent , Adult , Age Factors , Aged , Alanine Transaminase/blood , Antiviral Agents/adverse effects , Aspartate Aminotransferases/blood , Biomarkers/blood , Drug Therapy, Combination , Egypt , Female , Hepatitis C, Chronic/blood , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/virology , Humans , Liver/diagnostic imaging , Liver/enzymology , Liver/virology , Liver Cirrhosis/blood , Liver Cirrhosis/diagnosis , Liver Cirrhosis/virology , Male , Middle Aged , Platelet Count , Predictive Value of Tests , Reproducibility of Results , Retrospective Studies , Sofosbuvir/adverse effects , Sustained Virologic Response , Time Factors , Treatment Outcome , Viral Load , Young AdultABSTRACT
BACKGROUND: The present study aimed at evaluation of the usefulness of point shear wave elastography (pSWE) in characterization of FLL(s) by quantifying their stiffness. METHODS: In total, 197 patients (mean age was 56.57 years) with FLL(s) on conventional ultrasound were included. Final diagnoses, confirmed by imaging and/or biopsy whenever possible, included hepatocellular carcinoma (HCC) (n = 143), metastasis (n = 36), hemangioma (n = 16), and focal nodular hyperplasia (n = 2). Stiffness evaluation was performed by pSWE. Stiffness ratio (lesion to background liver) was calculated. ROC analysis was performed to evaluate the diagnostic accuracy of the stiffness value and stiffness ratio and to extract the optimal cutoff values for characterisation of FLL(s). RESULTS: HCC was significantly softer than its surrounding liver parenchyma [5.43 (3.03) vs. 17.05 (8.53) kPa, p <0.001]. However, the stiffness values for the other examined FLLs were comparable to their surrounding liver parenchyma. No significant difference was detected across different types of metastases or between metastases and surrounding liver (p>0.05). Stiffness ratio was superior to stiffness value in discrimination of HCC from metastasis (AUROC, 0.91 vs. 0.51 respectively). CONCLUSION: pSWE could provide a complementary information about FLLs especially in differentiation between HCCs from metastases.
