BACKGROUND:A rapid decline of liver stiffness (LS) was detected by non-invasive methods in patients with chronic hepatitis C (HCV) infection during treatment with direct-acting antivirals (DAA). OBJECTIVE:To investigate the influence of inflammation on LS. METHODS:We prospectively examined LS by sonographic shear-wave elastography in 217 patients during DAA therapy from treatment initiation (BL) to 12 weeks after end of therapy (SVR12). Demographic data, laboratory findings and serum levels of cytokines were determined. RESULTS:Values of LS decreased from 1.86 m/s to 1.68 m/s (p = 0.01) which was most pronounced in patients who had F4 fibrosis at BL (3.27 m/s to 2.37 m/s; p < 0.001). Initially elevated values of aminotransferases, ferritin, IgG (p < 0.001 each) and international normalized ratio (p < 0.003) declined, thrombocyte count (p = 0.007) increased. Correlations of these laboratory parameters with BL levels of LS measurement (LSM) were most apparent in patients with F1-F3 fibrosis. Tumor necrosis factor (TNF)-α (p = 0.031), interleukin (IL)-10 (p = 0.005) and interferon y inducible protein (IP)-10 (p < 0.001) decreased in parallel with LSM under DAA therapy and corelated with BL values. CONCLUSION:Decrease of systemic inflammatory parameters correlated with LSM under DAA therapy. We conclude that regression of LSM is attributable to the decline of inflammation rather than reflecting fibrosis.

中文翻译：

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通过剪切波弹性成像评估的肝脏硬度与 DAA 治疗期间慢性 HCV 感染患者的免疫调节蛋白同时下降

背景：在使用直接作用抗病毒药物 (DAA) 治疗期间，慢性丙型肝炎 (HCV) 感染患者通过非侵入性方法检测到肝脏硬度 (LS) 迅速下降。目的：探讨炎症对LS的影响。方法：我们前瞻性地通过超声剪切波弹性成像检查了 217 名 DAA 治疗期间从治疗开始 (BL) 到治疗结束后 12 周 (SVR12) 的患者的 LS。测定人口统计学数据、实验室检查结果和血清细胞因子水平。结果：LS 值从 1.86 m/s 下降到 1.68 m/s（p = 0.01），这在 BL 时 F4 纤维化的患者中最为明显（3.27 m/s 到 2.37 m/s；p < 0.001）。最初升高的转氨酶、铁蛋白、IgG（每个 p < 0.001）和国际标准化比率（p < 0.003）下降，血小板计数 (p = 0.007) 增加。这些实验室参数与 LS 测量 (LSM) 的 BL 水平的相关性在 F1-F3 纤维化患者中最为明显。肿瘤坏死因子 (TNF)-α (p = 0.031)、白细胞介素 (IL)-10 (p = 0.005) 和干扰素 y 诱导蛋白 (IP)-10 (p < 0.001) 在 DAA 治疗下与 LSM 平行下降，并且相关与 BL 值。结论：在DAA治疗下，与LSM相关的全身炎症参数降低。我们得出结论，LSM 的消退归因于炎症的减少，而不是反映纤维化。005) 和干扰素 y 诱导蛋白 (IP)-10 (p < 0.001) 在 DAA 治疗下与 LSM 平行下降并与 BL 值相关。结论：在DAA治疗下，与LSM相关的全身炎症参数降低。我们得出结论，LSM 的消退归因于炎症的减少，而不是反映纤维化。005) 和干扰素 y 诱导蛋白 (IP)-10 (p < 0.001) 在 DAA 治疗下与 LSM 平行下降并与 BL 值相关。结论：在DAA治疗下，与LSM相关的全身炎症参数降低。我们得出结论，LSM 的消退归因于炎症的减少，而不是反映纤维化。