Bert Florian, Stahmeyer Jona Theodor, Parpalea Andra-Livia, Rossol Siegbert
Department of Internal Medicine, Krankenhaus Nordwest, Frankfurt/Main, Germany.
Institute for Epidemiology, Social Medicine and Health Systems Research, Medical School, Hannover, Germany.
Gastroenterology Res. 2021 Feb;14(1):31-40. doi: 10.14740/gr1347. Epub 2021 Feb 19.
Chronic active hepatitis C virus (HCV) infection is a major public health problem and causes liver fibrosis (LF) up to liver cirrhosis (LC). LF can be estimated by non-invasive, easy handling methods. With implementation of new HCV therapies, elimination rates of HCV are near 100%, resulting in less clinical complications and costs. The aim of our study was to evaluate the positive influence of HCV treatment on liver stiffness by non-invasive assessments of LF.
Sixty-two patients with HCV were treated with antiviral drug regimes. Serological fibrosis scores and ultrasound elastography (acoustic radiation force impulse and shear wave elasticity imaging (ARFI-SWEI)) were used for LF assessment on day 0 and 6 months after therapy.
Antiviral treatment was successful in all cases. ARFI-SWEI measurements showed an improvement of all LF stages. Results of serological markers and scores were heterogeneous. Significant positive effects of treatment were seen for aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) scores, only. Further Pearson's coefficient showed moderate till very high correlations for ARFI-SWEI and FIB-4/APRI scores.
Today HCV therapy is able to cure HCV. Positive influences are improvement of LF stages. ARFI-SWEI, APRI and FIB-4 score are useful, easy handling tools to verify positive influence of HCV treatment on LF alone or in combination.
慢性丙型肝炎病毒（HCV）感染是一个重大的公共卫生问题，可导致肝纤维化（LF）直至肝硬化（LC）。LF可通过非侵入性、易于操作的方法进行评估。随着新型HCV疗法的应用，HCV的清除率接近100%，从而减少了临床并发症和费用。我们研究的目的是通过对LF的非侵入性评估来评价HCV治疗对肝脏硬度的积极影响。
62例HCV患者接受抗病毒药物治疗。在治疗第0天和治疗6个月后，采用血清纤维化评分和超声弹性成像（声辐射力脉冲和剪切波弹性成像（ARFI-SWEI））对LF进行评估。
所有病例的抗病毒治疗均成功。ARFI-SWEI测量显示所有LF阶段均有改善。血清学标志物和评分的结果存在异质性。仅天冬氨酸转氨酶与血小板比值指数（APRI）和纤维化-4（FIB-4）评分显示出治疗的显著积极效果。进一步的Pearson系数显示ARFI-SWEI与FIB-4/APRI评分之间存在中度至高度相关性。
如今HCV疗法能够治愈HCV。积极影响是LF阶段得到改善。ARFI-SWEI、APRI和FIB-4评分是单独或联合验证HCV治疗对LF的积极影响的有用且易于操作的工具。
