Resumen de Respuesta viral sostenida con interferón pegilado y ribavirina conduce a la normalización de la rigidez hepática en pacientes infectados por el virus de la hepatitis C
Juan Macías, Antonio Rivero Román, Celia Cifuentes Barrios, Angela Camacho, Karin Neukam, Antonio Rivero Juárez, José A. Mira-Escarti, Julián de la Torre Cisneros, Jesús Gómez Mateos, Juan Antonio Pineda Vergara
Introduction Pegylated interferon plus ribavirin (Peg-IFN/RBV) therapy leads to improvements in liver stiffness measurements (LSM) in hepatitis C virus (HCV)-infected patients. However, the rate of LSM return to normal values in response to Peg-IFN/RBV is unclear. Thus, our aim was to assess the probability and factors associated with LSM normalization in HCV-infected patients receiving Peg-IFN/RBV.
Methods This prospective observational longitudinal study included 160 HCV-infected patients, 111 (69%) with human immunodeficiency virus and receiving Peg-IFN/RBV, with baseline LSM =7 kPa. The outcome variable was LSM normalization, i.e. a stable decrease in LSM below 7 kPa after starting Peg-IFN/RBV.
Results After starting Peg-IFN/RBV, 56 [35%, 95% confidence interval (95% CI): 28�42%] patients showed LSM normalization. The probability of LSM normalization was 21% (95% CI: 13.2�32.4%) at 12 months, and 51.3% (95% CI: 39.9�63.9%) at 24 months after Peg-INF/RBV initiation for individuals with sustained virological response (SVR), and 8.3% (95% CI: 4�16.6%) at 12 months and 11.3% (95% CI: 6�20.7%) at 24 months for those without SVR (p < 0.001). For individuals with LSM =7 kPa 24 weeks after the pre-planned end of treatment, LSM normalizations were only observed among those with SVR. Achievement of SVR [Hazard ratio (HR, 95% CI): 6.84 (3.39�13.81)] and lack of baseline cirrhosis [HR (95% CI): 4.17 (1.69�10)] were independently associated with LSM normalization after starting Peg-IFN/RBV.
Conclusions LSM normalizations during Peg-IFN/RBV treatment are more likely, and occur earlier among patients with SVR. In addition, LSM normalizations continue 24 weeks after the scheduled end of therapy, but only among individuals who reach SVR.
