Reduction of liver stiffness by interferon treatment in the patients with chronic hepatitis C

Aim:  To assess the regression of liver fibrosis after interferon (IFN) treatment in patients with chronic hepatitis C, liver stiffness (LS) was measured repeatedly and the factors associated with reduction of LS were assessed. Methods:  LS was measured by transient elastography before treatment, at end of treatment (EOT), and 1 year and 2 years after EOT in 145 patients with chronic hepatitis C treated by IFN with or without ribavirin. Results:  In the patients with sustained virological response (SVR) (n = 93) and relapsers (n = 28), LS significantly decreased at EOT (median, 5.4 [interquartile range, 4.0–8.6] kilopascals [kPa], P < 0.0001 and 6.8 [4.5–8.9] kPa, P = 0.0023) and 1 year after EOT (5.3 [4.2–7.0] kPa, P < 0.0001 and 6.8 [4.5–9.3] kPa, P = 0.0204) compared with baseline (8.0 [5.0–11.9] kPa and 10.6 [7.0–16.6] kPa). In SVR patients, LS significantly decreased 2 years after EOT (5.3 [4.1–6.3] kPa) compared with baseline (P < 0.0001) and LS at EOT (P = 0.0034). Two points or greater reduction of deduced stage at last LS measurement was observed in 78% of SVR patients, 59% of relapsers and 15% of patients with non-virological response whose pretreatment deduced stages were F3–F4. Fibrosis stage, hyaluronic acid levels, duration of treatment, response to treatment and alanine aminotransferase levels were associated with a 2-point or greater decrease of deduced fibrosis stage. Conclusion:  IFN treatment reduced LS in SVR patients and relapsers. Significant reduction of LS is associated with milder fibrosis stage, lower hyaluronic acid levels, longer IFN treatment, virological response of SVR or relapse and higher alanine aminotransferase levels.