Liver stiffness measurements and FIB-4 are predictors of response to sofosbuvir-based treatment regimens in 7256 chronic HCV patients

ABSTRACT

Objectives: To assess the role of baseline liver stiffness (LS) by Transient elastography (TE) and FIB-4 in the prediction of virological response to sofosbuvir – based regimens in chronic HCV patients.

Methods: A retrospective, multicenter study including 7256 chronic HCV patients who received different sofosbuvir–based regimens. Baseline demographic and laboratory data were recorded. TE was performed with FIB-4 calculation at baseline.

Results: Sustained virological response at week 12 post-treatment (SVR12) was 91.4%. Pretreatment TE values and FIB-4 were significantly lower among sustained responders (17.8 ± 11.5 kPa, 2.66 ± 1.98, respectively) versus relapsers (24.5 ± 13.9 kPa, 4.02 ± 3.3, respectively). Best cutoff levels for LS by TE and FIB-4 score for prediction of failure to treatment response were 16.7 kPa and 2.4, respectively. Among different treatment protocol, patients with FIB-4 > 2.4, TE values >16.7 kPa are more prone to treatment failure except when using SOF/SIM treatment regimens.

Conclusion: Baseline LS by TE and FIB-4 score may be useful for predicting treatment outcome in the new era of DAAs and could be integrated into pretreatment assessment of chronic HCV patients for better optimization of patient management.

KEYWORDS:

• Chronic hepatitis C virus
• transient elastography
• FIB-4 score
• predictor
• sofosbuvir-based regimens

Article highlights

• Sofosbuvir-based therapy is a highly efficient antiviral therapy for HCV.

• LS by TE and FIB-4 at a cutoff level of 16.7 kPa and 2.4, respectively, have capability for prediction of failure to treatment response.

• In multivariate regression analysis, Liver stiffness was shown to be more predictive to failure of treatment if level >16.7 kPa than FIB-4.

• Baseline liver stiffness by TE and FIB-4 may be useful for predicting treatment outcome in the new era of DAAs.

Declaration of interest

W. Doss has served as an investigator or speaker for Gilead Sciences. G. Esmat has served as an investigator, speaker or advisory board member for Abbvie, Gilead Sciences, Marcyrl, Pharco and Roche. I. Waked has served as an investigator, speaker or advisory board member for Abbvie, Eva Pharma, Gilead Sciences, Janssen, Marcyrl, Onxio, Pharco and Roche.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has declared that they have received honoraria or speakers’ fees from Abbvie, Gilead, Janssen-Cilag, Merck Sharp & Dohme, and ViiV Healthcare. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.