Post-treatment LSM rather than change during treatment predicts decompensation in patients with cACLD after HCV cure

Abstract

Background & Aims: Baveno VII has defined a clinically significant ( i.e. , prognostically meaningful) decrease in liver stiffness measurement (LSM) in cACLD as a decrease of >-20% associated with a final LSM -20 kPa. After HCV cure, FU-LSM decreased to a median of 10.9 kPa (-20 kPa: 465 [19.9%]) translating into a median LSM change of-5.3 (-8.8 to-2.4) kPa corresponding to-33.9 (-48.0 to-15.9) %. Patients achieving a clinically significant decrease (65.4%) had a significantly lower risk of hepatic decompensation (subdistribution hazard ratio: 0.12, 95% CI 0.04-0.35, p -20% (p p = 0.550). Conclusions: FU-LSM is key for risk stratification after HCV cure and should guide clinical decision making. LSM dynamics do not hold significant prognostic information in patients with FU-LSM 10-19.9 kPa, and thus, their consideration is not of sufficient incremental value in the specific context of HCV cure. (c) 2024 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).