ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> Category 9. ELASTOGRAPHY / LIVER STIFFNESS<br><b>Presentation Date:</b> Apr 15, 2010</P><h2 align='left'><B>LONGITUDINAL ASSESSMENT OF LIVER FIBROSIS USING TRANSIENT ELASTOGRAPHY AND FOUR BIOMARKERS IN HCV PATIENTS WITH F3-F4 FIBROSIS: RELATIONSHIP WITH ANTIVIRAL TREATMENT RESPONSE AND CLINICAL OUTCOME</B></h2> <p align='left'><b>L. Castera</b><sup>1,2</sup>*, P.-H. Bernard<sup>2</sup>, B. Le Bail<sup>3</sup>, J. Foucher<sup>1</sup>, W. Merrouche<sup>1</sup>, P. Couzigou<sup>1</sup>, V. de ledighen<sup>1</sup><br> <em><sup>1</sup>Hepatology, Hopital Haut Leveque, Bordeaux University Hospital, Pessac, <sup>2</sup>Hepatology, Hopital St Andre, Bordeaux University Hospital, <sup>3</sup>Pathology, Hopital Pellegrin, Bordeaux University Hospital, Bordeaux, France. *laurent.castera@chu-bordeaux.fr</em></p><br> <p align='justify'><b>Background & aim: </b>Non invasive assessment of liver fibrosis is gaining popularity but longitudinal data are still limited. The aim of this longitudinal study was to assess liver fibrosis evolution before and after antiviral therapy, using transient elastography (TE) and 4 biomarkers (FIB-4, APRI, Hepascore, and Fibrotest), in HCV patients with severe fibrosis according to treatment response and outcome.<br><b><b>Methods: </b></b> Among 800 HCV patients who underwent several TE and biomarkers determinations, 97 (male 64%; mean age 53±12 yrs; genotype 1 74%) with biopsy-proven severe fibrosis (Metavir F3: 27; F4: 70) and compensated liver disease were selected: 87 treated with peginterferon plus ribavirin and 10 untreated (contra-indication, refusal) serving as controls. Their clinical outcome (complication or death) was assessed prospectively until early 2009.<br><b><b>Results: </b></b> All patients underwent at least 2 determinations with non invasive methods (Pre- and Post-tx) with a mean follow-up of 41±14 months. 29 patients (33%) achieved a sustained virological response (SVR). Evolution over time of TE and biomarkers values (median) according to treatment response is shown in the following table: <br><br><table border=1> <tr><td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>Pre vs Post-tx</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>TE (kPa)</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>FIB-4</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>APRI</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>Hepascore</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>Fibrotest</span></td> </tr><tr><td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>Control (n=10)</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>29.6 vs 31.4</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>6.4 vs 8.4</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>2.5 vs 2.6</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>1.0 vs 1.0</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>0.87 vs 0.91</span></td> </tr><tr><td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>Non SVR (n=58)</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>15.1 vs 16.6</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>2.4 vs 3.5</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>1.3 vs 1.6</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>0.93 vs 0.42*</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>0.78 vs 0.85*</span></td> </tr><tr><td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>SVR (n=29)</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>13.5 vs 6.9*</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>1.8 vs 1.3*</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>0.8 vs 0.3*</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>0.53 vs 0.20**</span></td> <td width='16%' align='left'><span style='font-weight:normal; font-style:normal'>0.66 vs 0.53</span></td> </tr></table><i>[Table 1]</i><br /><br>*p< 0.01; **p< 0.05<br>A significant decrease in TE values and most biomarkers (FIB-4, APRI and Hepascore) was observed in patients achieving SVR. Fourteen patients (15%) had disease progression (complications 8 and death 6) during follow-up (mean: 50±12 months). Progression was significantly associated with absence of treatment (untreated 50% vs. treated 10.6%, p< 0.01) and non response to therapy (non SVR 15.8% vs. SVR 0%, p< 0.02). None of the 16 patients with post-tx TE values < 7.0 kPa developed any complication whereas 18% of the patients with TE values >7.0 kPa had disease progression (p< 0.05).<br><b><b>Conclusion: </b></b> SVR in HCV patients with severe fibrosis-cirrhosis is associated with significant decrease in TE and biomarkers (FIB-4, APRI and Hepascore) values and better outcome. None of the patients with TE values < 7.0 kPa after treatment developed any complication.<br><br></p> <br><a href='Session-P01-9.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>