Longitudinal liver stiffness assessment in patients with chronic hepatitis C undergoing antiviral therapy

PLoS One. 2012;7(10):e47715. doi: 10.1371/journal.pone.0047715. Epub 2012 Oct 17.


Background/aims: Liver stiffness (LS) measurement by means of transient elastography (TE) is accurate to predict fibrosis stage. The effect of antiviral treatment and virologic response on LS was assessed and compared with untreated patients with chronic hepatitis C (CHC).

Methods: TE was performed at baseline, and at weeks 24, 48, and 72 in 515 patients with CHC.

Results: 323 treated (62.7%) and 192 untreated patients (37.3%) were assessed. LS experienced a significant decline in treated patients and remained stable in untreated patients at the end of study (P<0.0001). The decline was significant for patients with baseline LS ≥ 7.1 kPa (P<0.0001 and P 0.03, for LS ≥ 9.5 and ≥ 7.1 kPa vs lower values, respectively). Sustained virological responders and relapsers had a significant LS improvement whereas a trend was observed in nonresponders (mean percent change -16%, -10% and -2%, for SVR, RR and NR, respectively, P 0.03 for SVR vs NR). In multivariate analysis, high baseline LS (P<0.0001) and ALT levels, antiviral therapy and non-1 genotype were independent predictors of LS improvement.

Conclusions: LS decreases during and after antiviral treatment in patients with CHC. The decrease is significant in sustained responders and relapsers (particularly in those with high baseline LS) and suggests an improvement in liver damage.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Elasticity Imaging Techniques
  • Female
  • Follow-Up Studies
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / physiopathology*
  • Hepatitis C, Chronic / virology
  • Humans
  • Liver / drug effects
  • Liver / physiopathology*
  • Liver / virology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / drug therapy
  • Liver Cirrhosis / physiopathology
  • Longitudinal Studies
  • Male
  • Middle Aged


  • Antiviral Agents

Grant support

This is an independent study, supported in part by Roche. Stella Martinez was granted by Fundación Banco Bilbao Vizcaya Argentaria (BBVA). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.