Buscar en
Medicina Clínica (English Edition)
Toda la web
Inicio Medicina Clínica (English Edition) Analysis of hepatic stiffness after viral eradication in a population with chron...
Journal Information
Vol. 156. Issue 7.
Pages 317-323 (April 2021)
Share
Share
Download PDF
More article options
ePub
Visits
0
Vol. 156. Issue 7.
Pages 317-323 (April 2021)
Original
DOI: 10.1016/j.medcle.2020.04.035
Analysis of hepatic stiffness after viral eradication in a population with chronic hepatitis C treated with DAAs
Análisis de la rigidez hepática después de la erradicación viral en una población con hepatitis C crónica tratada con AAD
Visits
...
Moris Sanginetoa, Chiara Valentina Luglioa,b, Tommaso Mastrofilippoa, Maria Teresa Zingaroa, Elsa Berardia, Gianfranco Antonicaa, Carlo Sabbàa, Nicola Napolia,
Corresponding author
nicola.napoli@uniba.it

Corresponding author. Department of Interdisciplinary Medicine, University of Bari, Bari, Italy.
a Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
b Present address: Department of Internal Medicine, Hospital San Pio da Pietrelcina, Castellaneta (Taranto), Italy
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (4)
Show moreShow less
Tables (2)
Table 1. Population baseline characteristics.
Table 2. Multiple regression analysis for stiffness regression (ΔStiffness). Steatosis grade considered as continuous variable (0 = no steatosis; 1=mild steatosis; 2=moderate steatosis; 3=severe steatosis).
Show moreShow less
Abstract
Introduction and objectives

Despite chronic hepatitis C (CHC) is still a global burden as the high morbidity and mortality, the recently approved direct-acting antivirals (DAAs) permit a very high rate of sustained virologic response (SVR) in these patients. The clinical improvement due to viral eradication is being documented, however it is not clear why a subset of patients does not benefit in terms of fibrosis regression or hepatocellular carcinoma (HCC) development. Aim of the study was to assess the hepatic stiffness regression at SVR24 and detect factors impacting stiffness course.

Patients and methods

Hepatic stiffness assessed by acoustic radiation force impulse (ARFI) and anthropometric- and biochemical parameters were retrospectively collected by 166 CHC patients treated with DAAs, form baseline and SVR24.

Results

Viral eradication significantly improved overall hepatic stiffness and other related hepatitis hallmarks such as ALT, AST, γGT, platelets count, AST to Platelets ratio Index (APRI), total- and LDL cholesterol. The multiple regression analysis showed that patients with baseline glucose > 110mg/dl presented a stiffness regression significantly lower when compared to low glucose patients (<110mg/dl), moreover baseline HbA1c strongly correlated with DeltaStiffness. 7 patients (4.2%) developed HCC and importantly, presented hyperglycaemia and no stiffness regression nor platelets count recover.

Conclusions

Although viral eradication with DAAs entails overall benefits, glycaemic decompensation negatively affects fibrosis regression and probably facilitates HCC development.

Keywords:
Hepatitis
Direct-acting antiviral
Fibrosis
Glucose
Metabolism
Hepatocellular carcinoma
Abbreviations:
CHC
DAAs
SVR
HCC
SVR24
ARFI
APRI
IFN
RBV
ΔStiffness
INR
BMI
Resumen
Introducción y objetivos

Aunque la hepatitis C crónica (CHC) sigue siendo una carga global debida a la alta morbilidad y mortalidad, los antivirales de acción directa (AAD) recientemente aprobados, permiten un índice muy alto de respuesta virológica sostenida (RVS) en estos pacientes. La mejoría clínica debida a la erradicación viral está siendo documentada, pero no está claro por qué un subconjunto de pacientes no se beneficia en términos de regresión de fibrosis o desarrollo de carcinoma hepatocelular (HCC). El objetivo de este estudio fue evaluar la regresión de la rigidez hepática en SVR24 y detectar los factores que afectan el curso de la rigidez.

Pacientes y métodos

La rigidez hepática evaluada por la radiación acústica de la fuerza de impulso (ARFI) y los parámetros antropométricos y bioquímicos fueron recolectados retrospectivamente por 166 pacientes con CHC tratados con ADD, desde el punto de partida y SVR24.

Resultados

La erradicación viral mejoró significativamente la rigidez hepática general y otros signos relacionados con la hepatitis, como ALT, AST, γGT, conteo de plaquetas, índice da razão AST/plaquetas (APRI), colesterol total y LDL. El análisis de regresión múltiple mostró que los pacientes con glucosa basal >110 mg/dL tuvieron una regresión de rigidez significativamente inferior en comparación con los pacientes con glucosa baja (<110 mg/dL), además la HbA1c de referencia se correlacionó fuertemente con DeltaStiffness. Siete pacientes (4,2%) desarrollaron CHC y, lo que es más importante, presentaron hiperglucemia y no hubo regresión de rigidez ni recuperación del conteo de plaquetas.

Conclusiones

A pesar de que la erradicación viral con AAD conlleva diversos beneficios, la descompensación glucémica afecta negativamente la regresión de la fibrosis y probablemente facilita el desarrollo de CHC.

Palabras clave:
Hepatitis
Antiviral de acción directa
Fibrosis
Glucosa
Metabolismo
Carcinoma hepatocelular

Article

These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Clínica (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos