Liver stiffness becomes stable in patients with chronic hepatitis C three months after ALT normalization due to antiviral therapy

Objective To investigate the time for liver stiffness measurement ( LSM) to become stable in chronic hepatitis C ( CHC) patients with elevated alanine aminotransferase ( ALT) levels after ALT normalization due to antiviral therapy. Methods CHC patients who sought initial treatment at Peking University People's Hospital were screened for elevated ALT levels from May 2011. Liver stiffness was determined by FibroScan. A total of 29 patients had been included in the study by September 2012, who were followed up regularly after antiviral treatment. ALT tests were repeated every four weeks and LSM every eight weeks until their medians did not change significantly. Comparisons of matched data at two adjacent time points were made with the non- parametric Wilcoxon test, while multiple comparisons of repeated measurements were performed using Bonferroni correction. Correlation between two variables was analyzed with the Spearman rank test. Results Patients were followed up until 24 weeks after antiviral treatment, and 24 patients were included in analysis. The median ALT levels were 64, 26, 21, 20, and 22 U / L at baseline and 4, 8, 12, and 24 weeks, respectively ( P = 0. 000, 0. 006, 0. 337, and 0. 109 for comparisons between two adjacent values) . ALT decreased significantly below 1 ULN at 4 weeks after antiviral therapy and stabilized at 8 weeks.The median LSM values were 8. 7, 7. 8, 6. 8, and 6. 7 kPa at baseline and 8, 16, and 24 weeks, respectively ( P = 0. 009, 0. 001, and0. 188 for comparisons between two adjacent values) . LSM decreased significantly within 16 weeks after antiviral therapy and stabilized afterwards. LSM stabilized 12 weeks after ALT normalization. Conclusion LSM becomes stable in CHC patients with elevated ALT levels three months after ALT normalization due to antiviral therapy.