Liver stiffness measurement is a potent predictor of histological fibrosis regression after hepatitis C virus clearance.

ABSTRACT

BACKGROUND: Most of the studies on fibrosis regression prediction were based on noninvasive fibrosis markers and differ greatly. The 'Beijing fibrosis classification' can use histological results to classify fibrosis into progressive or 'nonprogressive' according to fibrotic septal morphology. We use this standard which served as the gold standard in order to find fibrosis regression predictors. AIM: To study the predictors of fibrosis regression after hepatitis C virus clearance according to histological fibrosis staging by the 'Beijing fibrosis classification'. MATERIALS AND METHODS: This was a prospective cohort study. A total of 68 patients with advanced liver fibrosis or compensated cirrhosis who achieved sustained virological response were enrolled. Patients with the Ishak scores lower than 3 seemed to have fibrosis regression. The others were divided into the fibrosis progressive group and the nonprogressive group according to the 'Beijing fibrosis classification'. Predictors of fibrosis regression were studied by logistic regression using baseline factors and the dynamic change in noninvasive fibrosis factors. RESULTS: Eighteen patients were assigned to the progressive group, and the others were assigned to the nonprogressive group. The baseline liver stiffness measurements (LSMs) of the progressive and nonprogressive groups were 14.35 (11.3, 27.3) kPa and 11.3 (8.3, 14.2) kPa, respectively, P = 0.02. The baseline LSM was the only predictor of fibrosis progression. With a cutoff of 11.85 kPa, the AUC was 0.71 (0.5, 0.9), and the negative predictive value was 0.92. CONCLUSIONS: The baseline LSM was found to be the only predictor of fibrosis regression, 11.85 kPa is a possible 'hepatic fibrosis return point'.