In patients with mild chronic hepatitis C (CHC), body mass index (BMI) <24 and liver stiffness measures (LSM) <5.9, the likelihood of cirrhosis progression is very low, allowing for a significant spacing of noninvasive assessments over time. Researchers evaluated the usefulness of consecutive LSM, APRI, FIB-4 and Forns scores to predict disease progression in areas with limited access to antiviral therapy. Patients with CHC and at least 2 annual LSM within 3 years were followed for a minimum of 5 years. Noninvasive scores were assessed. They found:

• 623 non-cirrhotic patients were included.
• Median baseline LSM was 6.6 kPa.
• During a median follow-up of 6 years, 61 (9.7%) patients developed cirrhosis.
• Baseline LSM and Forns were highly predictive of cirrhosis development.
• Baseline BMI ≥24 kg/m² and LSM ≥5.0 kPa were associated to progression.