A recent retrospective cohort study in Alimentary Pharmacology & Therapeutics determined that FibroScan®, a non-invasive exam that correlates well with the presence of advanced liver fibrosis and clinically significant portal hypertension in patients with hepatitis C virus (HCV) infection, can be used to measure liver stiffness either before or after anti-viral treatment. This is valuable because it has been suggested that liver stiffness, measured either before or after anti-viral treatment for HCV, is associated with the development of hepatocellular carcinoma (HCC), decompensated liver disease and death.
The study found that FibroScan®-derived liver stiffness decreases after anti-viral treatment for hepatitis C virus (HCV) infection, which may affect the associations and interpretation of liver stiffness.
The study identified U.S. veterans who initiated HCV treatment and had at least one liver stiffness before (n = 492) or after (n = 877) HCV therapy.
In the post-treatment liver stiffness cohort, during a mean follow-up of 27.3 months, 21 (2.4%) developed decompensated cirrhosis, 26 (3.0%) developed HCC and 57 (6.5%) died or underwent liver transplant. Compared to patients with post-treatment liver stiffness ≤12.5 kPa, those with post-treatment liver stiffness >20 kPa, had higher rates of developing decompensated cirrhosis (adjusted HR 3.85, 95% CI 1.29-11.50) and the composite outcome of death, liver transplant, decompensated cirrhosis or HCC (adjusted HR 1.95, 95% CI: 1.07-3.56).
Post-treatment liver stiffness >20 kPa, but not pre-treatment liver stiffness, was independently associated with the development of decompensated cirrhosis and the composite outcome in multivariable analyses.
Ultimately, the researchers concluded that measuring liver stiffness with FibroScan should be considered after anti-viral treatment because it predicts adverse outcomes even beyond routinely available clinical predictors.
FibroScan® is a rapid and painless examination that can accurately assess liver health to help halt the progression of fatty liver disease. This easily implemented tool is available for early detection and monitoring at the point of care for primary care physicians and specialists.