ArticleBMC gastroenterology2026
Liver stiffness by non-invasive tests predicts hepatocellular carcinoma and liver-related complications following viral eradication with direct-acting antivirals in chronic hepatitis C: a retrospective cohort study.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHigh sustained virological response (SVR) was achieved after direct-acting antiviral (DAA) treatment in patients with chronic hepatitis C viral (HCV) infection. Nevertheless, the factors predicting hepatocellular carcinoma (HCC) and liver-related complications (LRC) following SVR are required.
methodsHCV-infected patients who received DAA and achieved SVR at King Chulalongkorn Memorial Hospital, Thailand during 2011 and 2021 were enrolled. Liver stiffness was measured by transient elastography (TE), AST-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) scores, were collected at pre-treatment and within 12 months after SVR. Cox proportional hazard model assessed predictors of HCC and LRC.
resultsA total of 355 participants were enrolled. During the median follow-up period of 27 months, 15 (4.2%) and 24 (6.8%) developed HCC and LRC. Baseline TE showed the highest AUROC of 0.82 and predicted HCC with an adjusted hazard ratio (aHR) of 1.03 [95% confidence interval (CI) 1.00-1.09]. Baseline TE ≥ 13 kPa was associated with LRC with aHR of 3.28 (95%CI 1.17-9.19). In a subgroup analysis of 168 patients with post-treatment liver stiffness, the TE, APRI, and FIB-4 after SVR significantly declined. In the multivariate analysis, only TE ≥ 13 kPa after SVR anticipated HCC and LRC with aHR of 7.75 (95%CI 1.62-37.20) and 3.36 (95%CI 1.09-10.38).
conclusionsBaseline TE independently predicted HCC and LRC in HCV-infected patients with SVR after DAA therapy. In the subgroup analysis, liver fibrosis regression was observed after SVR. Additionally, post-treatment TE might more reliably anticipate adverse outcomes than pre-treatment values.
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