Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis C patients

Table 1 Demographic and clinical variables in patients with chronic hepatitis C stratified by treatment status (n = 813)

Variables	HCV treated	HCV untreated
	(n = 419 (51.5%)]	[n = 394 (48.5%)]
Age (yr) [mean (SD)]	56.54 (8.26)	56.14 (9.02)
Male sex [n (%)]	285 (68.02)	234 (59.39)
Race [n (%)]
Black	339 (80.91)	303 (77.49)
Other	18 (4.30)	20 (5.12)
White	62 (14.80)	68 (17.39)
Smoking history
Non-smoker	70 (16.71)	98 (25.00)
Current smoker	216 (51.55)	183 (46.68)
Former smoker	133 (31.74)	111 (28.32)
Co-infections [n (%)]
HIV	184 (43.91)	113 (28.68)
HBV	9 (2.15)	15 (3.81)
HCV RNA at baseline, IU/mL [median (Q1, Q3)]	2220000 (803000, 6606934)	2340000 (693015, 5924209)
Biochemistry
AST, IU/L, mean (SD)	57.91 (44.75)	46.38 (31.13)
ALT, IU/L, mean (SD)	56.63 (51.54)	51.52 (59.04)
Bilirubin < 2 mg/dL [n (%)]	393 (97.52)	359 (98.09)
Platelets, K/uL, median (Q1, Q3)	196.00 (155.50, 238.00)	209.00 (170.50, 255.00)
Hepatocellular carcinoma [n (%)]	4 (0.95)	2 (0.51)
Baseline diabetes [n (%)]	82 (19.57)	73 (18.53)
Baseline chronic kidney disease [n (%)]	41 (9.79)	26 (6.60)

HCV: Hepatitis C virus; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; HBV: Hepatitis B virus; HIV: human immunodeficiency virus.

Table 2 Transient elastography characteristics in patients with chronic hepatitis C according to treatment status

Variables	HCV treated (n = 419)	HCV untreated (n = 394)
Baseline liver stiffness (kPa) [mean (SD); range]	10.69 (9.48); 1.30-75.00	7.32 (6.10); 0.00-75.00
Change in kPa score [mean (SD)]	-2.78 (7.10)	0.51 (5.14)
Months between first and last TE [median (Q1, Q3)]	11.73 (7.41, 17.87)	12.68 (8.71, 16.94)
Months between first TE and DAA start [median (Q1, Q3)]	1.64 (0.95, 3.84)	–
Months between DAA end and last TE [median (Q1, Q3)]	4.17 (3.07, 10.96)	–

DAA: Direct-acting antiviral therapy; kPa: kilopascals; TE: Transient elastography

Table 3 Variables associated with the change in liver stiffness measurements in patients with chronic hepatitis C stratified by baseline kilopascals score

	All patients (n = 770)			Baseline kPa < 12 (n = 651)			Baseline kPa ≥ 12 (n = 119)
Variables	Effect estimate	95%CI	P	Effect estimate	95%CI	P value	Effect estimate	95%CI	P value
Antiviral treatment effect	-1.821	(-3.452, -0.191)	0.029	-1.487	(-2.820, -0.154)	0.029	-2.071	(-7.477, 3.335)	0.453
Baseline kPa	-0.557	(-0.699, -0.415)	< 0.001	-0.677	(-0.875, -0.480)	< 0.001	-0.600	(-0.818, -0.383)	< 0.001
Black race1	-0.797	(-1.775, 0.181)	0.110	-0.654	(-1.362, 0.054)	0.070	-2.747	(-7.304, 1.810)	0.237
Other race1	-0.497	(-1.901, 0.907)	0.488	-0.687	(-1.893, 0.520)	0.264	1.071	(-6.423, 8.566)	0.779
Age ≥ 502	0.663	(-0.165, 1.490)	0.117	0.949	(0.336, 1.563)	0.002	-0.204	(-4.089, 3.682)	0.918
Female gender	-0.210	(-0.843, 0.424)	0.517	-0.269	(-0.772, 0.235)	0.295	0.383	(-3.330, 4.096)	0.840
Diabetes	0.758	(-0.189, 1.705)	0.117	0.751	(-0.097, 1.599)	0.082	1.721	(-2.034, 5.475)	0.369
Current smoker	0.617	(-0.390, 1.624)	0.230	0.199	(-0.467, 0.865)	0.558	2.266	(-3.371, 7.903)	0.431
Former smoker	-0.258	(-1.155, 0.638)	0.572	-0.236	(-0.867, 0.395)	0.464	-0.554	(-6.741, 5.633)	0.861
HIV co-infected	0.468	(-0.230, 1.166)	0.189	0.254	(-0.286, 0.794)	0.356	2.040	(-1.292, 5.372)	0.230
Baseline ALT (per 10 units)	0.023	(-0.043, 0.089)	0.499	0.018	(-0.039, 0.075)	0.532	0.060	(-0.250, 0.370)	0.705
Time between first and last TE (untreated group) (mo)	0.001	(-0.090, 0.092)	0.975	-0.012	(-0.103, 0.078)	0.787	0.129	(-0.229, 0.488)	0.480
Time between first and last TE (treated group) (mo)3	0.016	(-0.051, 0.084)	0.634	0.008	(-0.044, 0.059)	0.772	0.004	(-0.215, 0.223)	0.972
Interaction of treatment and time	0.015	(-0.106, 0.136)	0.807	0.020	(-0.086, 0.126)	0.711	-0.125	(-0.523, 0.273)	0.537
Intercept	4.146	(2.365, 5.927)	< 0.001	4.781	(2.478, 7.084)	< 0.001	5.852	(-0.994, 12.698)	0.094

kPa: kilopascals; ALT: Alanine aminotransferase; TE: Transient elastography; HIV: Human immunodeficiency virus;

¹Effect of race estimated relative to white race as a reference.

²Reference ages 18-49.

³Estimated effect of time between first and last TE (treated group) is not directly included as a covariate in the model. Estimates for this row are derived from the antiviral treatment, time between first and last TE, and interaction terms.