Slow regression of liver fibrosis presumed by repeated biomarkers after virological cure in patients with chronic hepatitis C
Slow regression of liver fibrosis presumed by repeated biomarkers after virological cure in patients with chronic hepatitis C
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DOI：
10.1016/j.jhep.2013.05.015
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发表时间：
2013-10-01
影响因子：
25.7
通讯作者：
Katlama, Christine
中科院分区：
文献类型：
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作者：
Poynard, Thierry;Moussalli, Joseph;Katlama, Christine
背景和目标：慢性丙型肝炎是一种病毒学和纤维化疾病，持续病毒学应答（SVR）伴残余纤维化的患者可发生并发症。由于重复活检的局限性，没有研究评估治疗前后纤维化的动态变化。使用活检作为参考，FibroTest（TM）已被验证为纤维化进展和消退的生物标志物，具有类似的预后价值。目的是估计的影响SVR的动态纤维化推定FibroTest T.方法：在一个前瞻性队列，主要终点是10年的纤维化的回归率，定义为最低0.20减少FibroTest T，相当于一个METAVIR stage.Results：共933例患者都重复FibroTest T和瞬态弹性成像。10年时，在415例基线晚期纤维化患者中，108例SVR中有49%（95%CI 33-64%）消退，高于219例无应答者[23%（14-33%; p
Background & Aims: Chronic hepatitis C is both a virologic and fibrotic disease and complications can occur in patients with sustained virologic response (SVR) with residual fibrosis. Due to the limitations of repeated biopsies, no studies have assessed the dynamic of fibrosis before and after treatment. Using biopsy as reference, FibroTest(TM) has been validated as a biomarker of fibrosis progression and regression, with similar prognostic values. The aim was to estimate the impact of SVR on the dynamic of fibrosis presumed by FibroTest T.Methods: In a prospective cohort, the main end point was the 10-year regression rate of fibrosis, defined as a minimum 0.20 decrease in FibroTest T, equivalent to one METAVIR stage.Results: A total of 933 patients with both repeated FibroTest T and transient elastography were included. At 10 years, among the 415 patients with baseline advanced fibrosis, 49% (95% CI 33-64%) of the 108 SVR had a regression, which was greater than in the 219 non-responders [23% (14-33%; p