Liver stiffness assessed by shear-wave elastography declines in parallel with immunoregulatory proteins in patients with chronic HCV infection during DAA therapy

Article type: Research Article

Authors: Peschel, Georg^{a; *} | Grimm, Jonathan^a | Buechler, Christa^a | Gunckel, Manuela^a | Pollinger, Kirstin^a | Aschenbrenner, Elisabeth^a | Kammerer, Sylvia^b | Jung, Ernst-Michael^b | Haimerl, Michael^b | Werner, Jens^c | Müller, Martina^a | Weigand, Kilian^a

Affiliations: [a] Department of Gastroenterology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany | [b] Department of Radiology University Hospital Regensburg, Regensburg, Germany | [c] Department of Surgery University Hospital Regensburg, Regensburg, Germany

Correspondence: [*] Corresponding author: Georg Peschel, Franz-Josef-Strauss Allee 11, 93053 Regensburg, Germany. Tel.: +49 941 944 17152; Fax: +49 941 944 7002; E-mail: Georg.peschel@ukr.de.

Abstract: BACKGROUND:A rapid decline of liver stiffness (LS) was detected by non-invasive methods in patients with chronic hepatitis C (HCV) infection during treatment with direct-acting antivirals (DAA). OBJECTIVE:To investigate the influence of inflammation on LS. METHODS:We prospectively examined LS by sonographic shear-wave elastography in 217 patients during DAA therapy from treatment initiation (BL) to 12 weeks after end of therapy (SVR12). Demographic data, laboratory findings and serum levels of cytokines were determined. RESULTS:Values of LS decreased from 1.86 m/s to 1.68 m/s (p = 0.01) which was most pronounced in patients who had F4 fibrosis at BL (3.27 m/s to 2.37 m/s; p < 0.001). Initially elevated values of aminotransferases, ferritin, IgG (p < 0.001 each) and international normalized ratio (p < 0.003) declined, thrombocyte count (p = 0.007) increased. Correlations of these laboratory parameters with BL levels of LS measurement (LSM) were most apparent in patients with F1-F3 fibrosis. Tumor necrosis factor (TNF)-α (p = 0.031), interleukin (IL)-10 (p = 0.005) and interferon y inducible protein (IP)-10 (p < 0.001) decreased in parallel with LSM under DAA therapy and corelated with BL values. CONCLUSION:Decrease of systemic inflammatory parameters correlated with LSM under DAA therapy. We conclude that regression of LSM is attributable to the decline of inflammation rather than reflecting fibrosis.

Keywords: HCV, shear-wave elastography, inflammation, fibrosis

DOI: 10.3233/CH-211193

Journal: Clinical Hemorheology and Microcirculation, vol. 79, no. 4, pp. 541-555, 2021