Departments of Infectious Diseases, Hvidovre, Copenhagen University Hospital, Rigshospitalet, Denmark.
Eur J Gastroenterol Hepatol. 2011 Jan;23(1):41-4. doi: 10.1097/MEG.0b013e328341b891.
Transient elastography (TE) is a noninvasive and well validated method for measurement of liver stiffness. The aim of this study was to use TE to evaluate whether patients with sustained virological response (SVR) have lower liver stiffness than patients with non-SVR after treatment for chronic hepatitis C (CHC).
Patients with CHC, who had undergone liver biopsy before treatment with pegylated interferon and ribavirin, were included from four clinical centres in Denmark. All patients were examined with TE and had a blood test taken for hepatitis C virus-virus detection and analysis of alanine aminotransferase, platelet counts and hyaluronic acid.
For 110 (92%) of the 120 patients included, it was possible to obtain a successful measurement of liver stiffness. Of these, 71 (64.5%) had achieved SVR. Median follow-up time was 47 months. Patients with pretreatment minimal fibrosis (F0/F1) in their liver biopsy had median liver stiffness of 5.3 kPa for SVR versus 6.1 kPa for non-SVR (P=0.56). Patients with pretreatment moderate fibrosis (F2/F3) had median liver stiffness of 5.4 kPa for SVR versus 9.4 kPa for non-SVR (P<0.001). Median liver stiffness for patients with pretreatment cirrhosis (F4) was 6.8 kPa for SVR versus 24 kPa for non-SVR (P<0.001).
Examination with TE 4 years after treatment shows that patients with CHC, who have achieved SVR, have significantly lower liver stiffness than patients with non-SVR. This indicates that histological liver outcome improves during the first year after the treatment for CHC.
瞬时弹性成像（TE）是一种测量肝硬度的非侵入性和经过充分验证的方法。本研究旨在使用 TE 评估慢性丙型肝炎（CHC）治疗后获得持续病毒学应答（SVR）的患者与未获得 SVR 的患者的肝硬度是否更低。
从丹麦的四个临床中心纳入了接受聚乙二醇干扰素和利巴韦林治疗前进行过肝活检的 CHC 患者。所有患者均接受 TE 检查，并进行了丙型肝炎病毒检测和丙氨酸氨基转移酶、血小板计数和透明质酸分析的血液检查。
对于纳入的 120 例患者中的 110 例（92%），成功获得了肝硬度的测量值。其中，71 例（64.5%）获得了 SVR。中位随访时间为 47 个月。肝活检中存在预处理最小纤维化（F0/F1）的患者，SVR 的中位肝硬度为 5.3 kPa，而非 SVR 的中位肝硬度为 6.1 kPa（P=0.56）。预处理中纤维化程度为中度（F2/F3）的患者，SVR 的中位肝硬度为 5.4 kPa，而非 SVR 的中位肝硬度为 9.4 kPa（P<0.001）。预处理肝硬化（F4）的患者，SVR 的中位肝硬度为 6.8 kPa，而非 SVR 的中位肝硬度为 24 kPa（P<0.001）。
CHC 治疗 4 年后进行 TE 检查显示，获得 SVR 的 CHC 患者的肝硬度明显低于未获得 SVR 的患者。这表明 CHC 治疗后第一年组织学肝脏结局得到改善。
