Imad Asaad, MD1, Mohamed Eisa, MD1, Tae Hoon Lee, MD2, Osama Hamid, MD1, Annumeet A. Sandhu, DO1, Amy Calderon, DO, PharmD1
1MetroHealth Medical Center, Cleveland, OH; 2Icahn School of Medicine at Mount Sinai, New York, NY
Introduction: The availability of noninvasive fibrosis measures coupled with high sustained viral response (SVR) rates has shifted the paradigm in the management of HCV infection in the direct-acting antiviral (DAA) era. Although these noninvasive tests are valuable in evaluating hepatic fibrosis prior to HCV therapy, use of these measures in monitoring fibrosis regression after HCV eradication is currently limited.
There is evidence that patients who achieve SVR after therapy have a reduced risk of liver-related complications 1 .This is likely attributed to the regression of fibrosis after HCV eradication.2 Other comorbidities, such as obesity, nonalcoholic steatohepatitis and diabetes mellitus may also contribute to liver-related complications. 3-4.
The aim of this study is to evaluate the effect of metabolic syndrome components on liver stiffness measurement (LSM) after HCV eradication.
Methods: A retrospective study of 65 HCV monoinfected patients who received DAA and achieved SVR located in a safety net hospital in Cleveland. All Patients had pretreatment LSM of more than 7k Pa. Patient’s with Fibrosis stage F4 had CP class A. Fibrosis was evaluate within 12 months before treatment and 12-24 months after SVR using Transient Elastography. Other collected parameters included BMI, history of DM, HLD and HTN, HbA1c, LDL, HDL and TGs. Demographics and hepatitis C genotype (GT) were also collected. Statistical analysis was performed using descriptive analysis, Anova, Univariate regression and Multivariate regression to compare variables for statistical significance.
Results: Among all subjects (n=65). 64.6% were male. 61.5% had Genotype 1a, 26.2% had genotype 1b and 6.2% had genotype 2. 33.8% were diabetic, 64.6% had hyperlipidemia, and 66.2% patients had hypertension.
The mean pre-treatment LSM was 14.4kPa (SD 10.0) and the mean post-treatment LSM was 9.33 kPa (SD 5.3). The mean of delta-stiffness was 5.1 kPa (SD 9.7). 53.8% patients dropped their LSM by 3 kPa or more after SVR.
In univariate logistic regression, age (p=0.675), race (p=0.11), genotype (p=0.688), BMI (p=0.709), diabetes (p=0.661), hyperlipidemia (p=0.743), and hypertension (p=0.545) failed to show any significant correlation with significant drop (≥ 3kPa) in liver stiffness measurement.
Discussion: Sustained viral response after direct-acting antiviral (DAA) therapy leads to significant improvement in LSM within 48 months of therapy completion. Metabolic syndrome components has no significant effect on LSM improvement after SVR.
Citation: Imad Asaad, MD; Mohamed Eisa, MD; Tae Hoon Lee, MD; Osama Hamid, MD; Annumeet A. Sandhu, DO; Amy Calderon, DO, PharmD. P1527 - THE EFFECT OF METABOLIC SYNDROME COMPONENTS ON LIVER STIFFNESS MEASUREMENT VALUES AFTER HCV ERADICATION. Program No. P1527. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.