Changes in liver fibrosis in patients with chronic hepatitis C after successful direct‐acting antiviral therapy

Abstract

Introduction and Objectives After successful treatment of hepatitis C virus (HCV) infection with direct‐acting antivirals (DAAs), the stage of liver fibrosis decreases over time. Here, we aimed to assess the changes in the liver fibrosis stage using transient elastography (TE) after successful DAA therapy in HCV‐infected cirrhotic patients who were referred to Shariati hospital from 2016 to 2017. Material and Methods In this observational cohort, all HCV‐infected cirrhotic patients who were treated with a combination of sofosbuvir/daclatasvir, had sustained virologic response (SVR), and had undergone pre‐ and post‐treatment TE, were enrolled. The primary outcome was the changes in TE parameters six months after the end of treatment compared with baseline. Results A total of 442 eligible subjects received DAA therapy. Overall, the SVR rate was 96.6%. Of these, 149 patients had completed the protocol and were enrolled. The mean age of patients was 56.1 ± 10.3 years and the predominant sex was male (77.9%). The median (Q1‐Q3) liver stiffness (LS) value at baseline was 26.3 kPa (18.1‐38 kPa), which significantly decreased to 20.9 kPa (12‐29.7 kPa) [z = −8.45, P‐value < .001]. Also, the liver steatosis of patients with baseline CAP ≥ 220 dB/m had a significant response to treatment [z = −2.3, P‐value = .023]. Based on multivariate analysis, a higher baseline liver fibrosis stage was the only determinant of LS values improvement in our study. Conclusion Successful HCV eradication in patients with liver fibrosis results in significant improvement in LS, even in cirrhotic patients.

Regression in hepatic fibrosis in elderly Chinese patients with hepatitis C receiving direct-acting antiviral treatment

“…Theoretically, HCV eradication by DAA treatment is expected to regulate the expression of SREBP and reduce adipogenesis in the liver, which subsequently reduces CAP, an alternative marker of hepatic steatosis. Some previous studies have confirmed this conjecture [ 41 , 42 ]. However, recent reports have also shown that successful HCV eradication by DAA therapy may cause an elevation in CAP [ 43 , 44 ].…”

Changes in Liver Steatosis Using Controlled Attenuation Parameter among Patients with Chronic Hepatitis C Infection Treated with Direct-Acting Antivirals Therapy Who Achieved Sustained Virological Response

“…The factors that were associated with an increase in CAP values from the baseline to SVR are represented by impaired fasting glucose (fasting plasma glucose at baseline 106.37 ±18.86 mg/dL vs. 114.96 ± 47. 19 The patients with steatosis had higher LSMs (7.1 ± 1.5 kPa; SVR12-8.3 ± 3.8 kPa, p = 0.038), while patients without steatosis did not have higher LSMs (7.5 ± 1.4; SVR12 5.5 ± 1.2 kPa, p < 0.0001) (Table 2). Thus, 38.2% of the patients with steatosis had advanced fibrosis (F3), while patients without steatosis did not have advanced fibrosis (Figure 3…”

“…Several recent studies have found a significant regression of liver fibrosis after DAA treatment, but on the other hand, data from the literature are limited and contradictory regarding steatosis [19,20]. Hence, this study evaluated changes in liver steatosis using a CAP in patients with HCV infection who achieved SVR after 12 weeks of therapy completion.…”

Long-Term Monitoring of Liver Fibrosis and Steatosis in Patients with Chronic Hepatitis C after Achieving a Sustained Virologic Response to Antiviral Therapy

“…В научной литературе данные о динамике стеатоза печени после достижения УВО противоречивы. Часть из них демонстрирует уменьшение САР ТМ по данным ТФ, в том числе и у пациентов с ЦП, через 12-24 недели после окончания терапии ПППД [32][33][34][35], другие, наоборот, прогрессию стеатоза печени [36][37][38]. В проведенном исследовании зарегистрирована высокая распространенность стеатоза печени как до начала ПВТ, так и при длительном мониторинге после достижения УВО.…”