Post–sustained Virologic Response Liver Stiffness May Underestimate Fibrosis After Direct Acting Antiviral-containing Therapy

Clinical Infectious Diseases - current i.. - 4m ago Preview

 
 
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To the Editor—Patients with chronic hepatitis C virus (HCV) and advanced fibrosis or cirrhosis remain at elevated risk of developing hepatocellular carcinoma (HCC), despite sustained virologic response (SVR) with direct-acting antivirals (DAAs), and therefore require ongoing HCC surveillance [1–4]. Vibration-controlled transient elastography (VCTE) is well validated as a non-invasive fibrosis surrogate in patients with active viremia [5]. However, data is lacking to support the American Gastroenterological Association’s recommendation to use the VCTE-measured liver stiffness (LS) cutoff of > 9.5 kPa to rule in/out ≥F3 fibrosis in patients post-SVR after DAA therapy [5].