ISSN ONLINE: 2558-815X
ISSN PRINT: 1584-9244
ISSN-L: 1584-9244

The role of shear wave elastography in the dynamic monitoring of fibrosis in patients with chronic hepatitis C with sustained virological response after direct acting antiviral therapy

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ABSTRACT

Introduction. In the last years, the non-invasive methods of evaluating liver fibrosis were imposed in the current medical practice.

The objective of the study was to evaluate the role of 2D Shear Wave elastography in the dynamic monitoring of liver fibrosis compared to a validated method – Fibromax.

Materials and methods. 37 patients with chronic hepatitis C infection and advanced fibrosis (F3/F4) who received treatment with Paritaprevir/Ritonavir + Ombitasvir + Dasabuvir were included. The evaluation was done at baseline, 12 weeks after the end of treatment and 48 weeks after therapy.

Results. There was a significant and positive correlation of high degree, according to the Spearman’s rho correlation coefficient, between 2D Shear Wave elastography and Fibromax, showing very similar results both at the beginning of therapy (p<0.001, R=0.726) and one year after its completion (p<0.001, R=0.961). The correlation between platelet count and the non-invasively estimated liver fibrosis degree is statistically significant, being moderately negative (p=0.009, R=0.426) – patients with low platelet count at baseline did not present an improvement of fibrosis or it was not statistically significant one year after stopping the treatment. Direct antiviral therapy with Paritaprevir/Ritonavir + Ombitasvir + Dasabuvir, besides the chronic hepatitis C eradication rate of 99-100%, also determines a statistically significant improvement (p<0.001) of the degree of liver fibrosis.

Conclusions. There is a strong correlation between the two non-invasive methods analyzed, which recommends routine use of 2D Shear Wave elastography alone or in combination with other tests. In addition to the remarkable effectiveness of the therapeutic regimen used (SVR rates >95%), there is also a significant improvement of fibrosis, which prevents progression to cirrhosis and hepatocellular carcinoma.

Keywords: elastography, two-Dimensional shear wave elastography, Fibromax, chronic hepatitis C, hepatic fibrosis.

Abbreviations

2D-SWE = 2-Dimensional Shear Wave Elastography

ALT = alanine aminotransferase

DAA = direct-acting antiviral agent

Exviera – Dasabuvir

HCV – Hepatitis C Virus

M0 = baseline, before starting the treatment

Full text sources https://doi.org/10.31688/ABMU.2019.54.4.12 How to cite Email to Author Format XML


Address for correspondence:
Mihaela C. OLARIU
National Institute of infectious Diseases”Prof. Dr. Matei Bals”, Bucharest, Romania
Address: Dr. Grozovici Str., No.1, Bucharest, Romania
E-mail: ol_cristina@yahoo.ro

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Olariu MC, Stoichitoiu EL, Nurciu A, Andriescu G, Olariu MH, Diaconu CC. The role of shear wave elastography in the dynamic monitoring of fibrosis in patients with chronic hepatitis C with sustained virological response after direct acting antiviral therapy. Arch Balk Med Union. 2019;53(4):699-704