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Liver fibrosis assessment by transient elastography in patients with liver cirrhosis after hepatitis C virus eradication

https://doi.org/10.47093/2218-7332.2020.11.1.26-37

Abstract

Direct-acting antivirals (DAAs) therapy is associated with fibrosis regression in patients with hepatitis C virus liver cirrhosis.

Aim. To study the dynamic of liver fibrosis in cirrhotic patients with a DAAs-induced sustained virological response (SVR).

Materials and methods. The retrospective cohort study included 80 cirrhotic patients (male — 43%, median age 54 years). Liver stiffness (LS) was measured by transient elastography before treatment and after SVR. Patients with LS improvement ≥30% were included in group 1, other patients — in group 2. Clinical, laboratory and instrumental parameters were assessed. Independent risk factors for the absence of LS improvement ≥30% were determined by binary logistic regression with the definition of odds ration (OR) and 95% confidence interval (CI).

Results. LS reduced from 21.35 (15.2; 27.7) to 13.5 [10.1; 20.0] kPa (p < 0.001), the median reduction was 5.1 [2.6; 11.0] kPa. Regression of fibrosis from F4 to F2 and F3 stages was observed in 16 (20%) and 19 (24%) of cases, respectively. Overall, 36 patients were included in group 1, 44 patients — in group 2. Platelet counts increased in group 1 compared to group 2 by 24.5% vs 5.2% (p = 0.014), a disappearance or reducing the size of esophageal varices were observed in 72% vs. 35% of cases (p = 0.035). Significant differences in ALT, AST, albumin, prothrombin time dynamics were not observed. Baseline albumin level ≤35 g/l is an independent risk factor for the absence of significant improvement of LS: OR 6.7 (95% CI 1.7–25.9, p = 0.006).

Conclusion. SVR leads to fibrosis regression to F2-F3 stages in 44% of patients. Baseline albumin level ≤35 g/l is an independent risk factor for the absence of significant improvement of LS.

About the Authors

E. A. Nabatchikova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Ekaterina A. Nabatchikova, Postgraduate, Department of Internal, Occupational diseases and Rheumatology

8/2, Trubetskaya str., Moscow, 119991
Tel.: + 7 (916) 482-19-92 



D. T. Abdurakhmanov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Dzhamal T. Abdurakhmanov, MD, PhD, DMSc, Professor, Department of Internal, Occupational diseases and Rheumatology

8/2, Trubetskaya str., Moscow, 119991



E. N. Nikulkina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Elena N. Nikulkina, Assistant Professor, Department of Internal, Occupational diseases and Rheumatology

8/2, Trubetskaya str., Moscow, 119991



T. P. Rozina
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Russian Federation

Teona P. Rozina, MD, PhD, Associate Professor, Department of Internal, Occupational diseases and Rheumatology, Sechenov First Moscow State Medical University (Sechenov University); Associate Professor, Department of Internal diseases, Faculty of Fundamental Medicine, M.V. Lomonosov Moscow State University

8/2, Trubetskaya str., Moscow, 119991
1, Leninskie Gory, Moscow, 119991 



E. L. Tanaschuk
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Elena L. Tanaschuk, MD, PhD, Assistant Professor, Department of Internal, Occupational diseases and Rheumatology

8/2, Trubetskaya str., Moscow, 119991



S. V. Moiseev
Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University
Russian Federation

Sergey V. Moiseev, MD, PhD, DMSc, Professor, Head of the Department of Internal, Occupational diseases and Rheumatology, Sechenov First Moscow State Medical University (Sechenov University); Professor, Department of Internal diseases, Faculty of Fundamental Medicine, M.V. Lomonosov Moscow State University

8/2, Trubetskaya str., Moscow, 119991
1, Leninskie Gory, Moscow, 119991 



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