Article Text

Download PDFPDF

PWE-116 Liver Stiffness Measurement Predicts Response to Anti-Viral Treatment in Patients with Chronic Hepatitis C Genotype 3
  1. L Christian1,
  2. A Nkhoma1,
  3. A Price1,2,
  4. M Schmid1,2,
  5. C Miller1,
  6. K Baxter1,
  7. M Bassendine1,2,
  8. S Mcpherson1,2
  1. 1Joint Viral Hepatitis Clinic, Freeman Hospital
  2. 2Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK


Introduction Chronic hepatitis C virus infection (HCV) is a common cause of cirrhosis and end-stage liver disease. Pegylated interferon (PEG-IFN) and ribavarin (RBV) is currently the treatment of choice for genotype 3 (G3) HCV resulting in a sustained virological response (SVR) in 70–80%. Advanced fibrosis is known to be associated with failure of antiviral therapy. Increasingly, liver stiffness measurement (LSM) is being used to non-invasively assess fibrosis. However, it is not known whether LSM predicts response to antiviral therapy and whether there are predictive cut-offs. Our aim was to assess whether baseline LSM can predict SVR in HCV G3 patients treated with PEG-IFN+RBV.

Methods Retrospective review of outcomes in naive patients with HCV G3 treated with PEG-IFN+RBV in our clinic from Jan 2007 to Oct 2011. Post transplant and co-infected patients were excluded. Patients with a valid LSM within 1 year of starting treatment who completed > 12wks and recorded outcome of treatment were included in the LSM analysis.

Results 144 patients (mean age 40±10 years, 56% male, 16% cirrhotic, and 42% high viral load) received PEG-IFN+RBV for HCV in the study period. 92% completed > 12 wks treatment. 92 (64%) of patients had a valid LSM (median 6.5kPa; 3.5kPa to 39.1kPa). 24% had a LSM > 10.6kPa consistent with advanced fibrosis. The overall SVR rate was 68%. 11% were lost to follow up and the outcome unknown. LSM was significantly associated with SVR (p = 0.001). The AUROC for LSM in predicting treatment response was 0.74 (95% CI 0.58–0.90). The optimum cut-off to predict non-SVR was 10.6kPa (69% sensitivity, 85% specificity). 90% with LSM ≤ 10.6kPa achieved SVR versus 47% with LSM > 10.6kPa (p < 0.001). All patients with low viral load (< 600,000 IU/ML) and LSM < 10.6 kPa who had > 12 wks treatment achieved SVR (n = 33).

Conclusion Fibrosis assessed non-invasively with LSM can help predict response to antiviral therapy in patients with HCV G3. LSM (> or < 10.6kPa) could be factored into treatment algorithms to determine the optimum treatment course lengths.

Disclosure of Interest None Declared.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.