Federica Iuculano (Italy)
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano; Università degli Studi di Milano Department of Pathophysiology and Transplantation, Unit of Internal Medicine and Metabolic DiseasesAuthor of 1 Presentation
NEW ONSET STEATOSIS BUT NOT PERSISTENT STEATOSIS PREVENTS HEPATIC FIBROSIS IMPROVEMENT AFTER VIRAL ERADICATION IN PATIENTS WITH CHRONIC HEPATITIS C: EVALUATION BY FIBROSCAN
Abstract
Background and Aims
Background: In patients with chronic hepatitis C (CHC), presence of steatosis before and after sustained virological response (SVR) has been demonstrated and linked to metabolic alterations. Aim: to define the impact of post SVR steatosis on fibrosis improvement evaluated by Fibroscan in CHC patients after viral eradication.
Methods
Methods: 794 patients with CHC achieving SVR were enrolled in 2 Italian Liver Units. Data were collected the day of DAAs starting and six months after SVR. Fibroscan diagnosed steatosis (by controlled attenuation parameter (CAP) ≥ 248 dB/m) and fibrosis (by liver stiffness measurement LSM).
Results
Results: Mean age was 64±16 ys, 50% males, genotype 3 in 7%. Patients with baseline steatosis (365, 46%) presented significantly higher baseline LSM values compared to their counterpart (10.6±7.8 vs 9.4±7.4 kPa; p=0.04). After SVR, steatosis (CAP ≥ 248 dB/m) developed in 125 out of 429 (29%) without steatosis at enrollment, whereas persisted in 243 (66%) of patients with baseline steatosis. LSM significantly reduced after SVR (10±7.6 vs 8.2±7.2 kPa, p<0.001), even in presence of hepatic steatosis post SVR (10.3±7.3 vs 8.2±6.6 kPa; p<0.001). However, when the analysis was differentiated between patients with persistence and new onset steatosis, a significantly reduction of LSM in patients with persistence (10.8±7.8 vs 8.0±5.7 kPa, p<0.001) but not in those with new onset steatosis (9.4±6.4 vs 8.7±8.0 kPa, p=0.12) was confirmed.
Conclusions
Conclusion: New onset steatosis but not persistence of baseline steatosis prevents fibrosis improvement after SVR, possibly suggesting the presence of two different type of post SVR steatosis.