Shear Wave Elastography for Assessing Liver Stiffness in HCV-Infected Kidney Transplant Recipients after Direct-Acting Antiviral Treatment: A Comparative Study with Magnetic Resonance Elastography

Abstract:
        Hepatitis C virus (HCV) infection can lead to hepatic fibrosis. The advent of direct-acting antivirals (DAAs) has substantially improved sustained virological response (SVR) rates. In this context, kidney transplant recipients (KTRs) are of particular interest due to their higher HCV infection rates and uncertain renal excretion and bioavailability of DAAs. We investigated liver stiffness after DAA treatment in 15 HCV-infected KTRs using ultrasound shear wave elastography (SWE) in comparison with magnetic resonance elastography (MRE). KTRs were treated with DAAs (daclatasvir and sofosbuvir) for three months and underwent SWE at baseline, end of therapy (EOT), and 3 (EOT+3) and 12 months (EOT+12) after EOT. Fourteen patients achieved SVR12. Shear wave speed (SWS)—as a surrogate parameter for tissue stiffness—was substantially lower at all three post-therapeutic timepoints compared with baseline (EOT: −0.42 m/s, p < 0.01; CI = −0.75–−0.09, EOT+3: −0.43 m/s, p < 0.01; CI = −0.75–−0.11, and EOT+12: −0.52 m/s, p < 0.001; CI = −0.84–−0.19), suggesting liver regeneration after viral eradication and end of inflammation. Baseline SWS correlated positively with histopathological fibrosis scores (r = 0.48; CI = −0.11–0.85). Longitudinal results correlated moderately with APRI (r = 0.41; CI = 0.12–0.64) but not with FIB-4 scores (r = 0.12; CI = −0.19–0.41). Although higher on average, SWE-derived measurements correlated strongly with MRE (r = 0.64). In conclusion, SWE is suitable for non-invasive therapy monitoring in KTRs with HCV infection.

SEEK ID: https://seek.lisym.org/publications/427

DOI: 10.3390/jcm12247547

Projects: LiSyM network

Publication type: Journal

Journal: Journal of Clinical Medicine

Citation: JCM 12(24):7547

Date Published: 1st Dec 2023

Registered Mode: by DOI

Authors: Salma Almutawakel, Fabian Halleck, Michael Dürr, Ulrike Grittner, Eva Schrezenmeier, Klemens Budde, Christian E. Althoff, Bernd Hamm, Ingolf Sack, Thomas Fischer, Stephan R. Marticorena Garcia

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Almutawakel, S., Halleck, F., Dürr, M., Grittner, U., Schrezenmeier, E., Budde, K., Althoff, C. E., Hamm, B., Sack, I., Fischer, T., & Marticorena Garcia, S. R. (2023). Shear Wave Elastography for Assessing Liver Stiffness in HCV-Infected Kidney Transplant Recipients after Direct-Acting Antiviral Treatment: A Comparative Study with Magnetic Resonance Elastography. In Journal of Clinical Medicine (Vol. 12, Issue 24, p. 7547). MDPI AG. https://doi.org/10.3390/jcm12247547
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Created: 5th Jun 2024 at 08:27

Last updated: 5th Jun 2024 at 08:28

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