Mauro E, et al. - The clinicians examined the degree of fibrosis regression (decrease ≥1 METAVIR stage) after the sustained virological response (SVR) and its associated factors in recurrent hepatitis C. In addition, they investigated the diagnostic capacity of noninvasive methods in the assessment of liver fibrosis and portal hypertension after viral clearance. In most patients, SVR after liver transplant (LT) induced fibrosis regression, leading to significant clinical benefits. Significant determinants of the likelihood of fibrosis regression were pre-treatment HVPG and liver stiffness measurement (LSM). Lastly, LSM accurately predicted the presence of advanced fibrosis and portal hypertension one year after SVR. Therefore, it could be used to determine monitoring strategies.

• A total of 112 HCV-infected LT recipients who achieved SVR between 2001 and 2015 were evaluated.
• The clinicians performed a liver biopsy before treatment and 12 months after SVR.
• Moreover, they determined HVPG, liver stiffness measurement (LSM) and ELF score at the same time points.

• In this study, 67% of the cohort presented fibrosis regression: 43% in recipients with cirrhosis and 72-85% in the remaining stages (p=0.002).
• Following SVR, HVPG, LSM and ELF significantly decreased.
• Significant improvement was noted in liver function, and survival was considerably better in patients achieving fibrosis regression.
• Independent predictors of fibrosis regression were the baseline HVPG and LSM as well as decompensations before therapy.
• LSM had a high diagnostic accuracy to discard the presence of advanced fibrosis and clinically significant portal hypertension 1 year after SVR (AUROCs 0.902 and 0.888).