Effect of DAAs on improvement of liver fibrosis assessed by transiet elastography and associated risk factors for accelerating liver fibrosis

Abstract

Background: Egypt started a national treatment program intending to provide cure for Egyptian HCV-infected patients. Yet, with the development of highly-effective direct acting antivirals (DAAs) for HCV, elimination of viral hepatitis has become a real possibility. This study aimed to evaluate the impact of DAAs on achievement of improvement in liver fibrosis, and to evaluate risk factors associated with progression of liver fibrosis in patients achieved sustained virological response (SVR). Method: the study included 300 patients diagnosed with chronic HCV infection started their treatment protocol form 2016 who were divided into two groups; Group I (150 patients) included patients who received Sofosbuvir + Simeprevir ± Ribavirin as dual or triple therapy (for 12 weeks) for HCV treatment, and Group II (150 patients) included patients who received Sofosbuvir + Daclatasvir ± Ribavirin as dual or triple therapy (for 12 weeks) for HCV treatment. All cases were subjected to complete history taking, thorough physical examination, routine laboratory investigations, pelviabdominal US together with transient elastography were ordered for all cases. Results: both HCV treatment regimens showed improvement in liver fibrosis, fibro scan parameters showed a significant decrease in both groups compared to the baseline as pretreatment examination revealed mean values of 9.81 and 9.75 in both groups respectively. After treatment, both groups had mean values of 8.11 and 8.05. Both groups showed a significant change compared to its pre-treatment value (p < 0.001). There was a significant negative correlation between fibro scan parameter decrease with age, BMI, and HbA1C levels. There was no difference in degree of improvement of liver fibrosis between both regimens. Conclusion: fibrosis regressed significantly after DAAs

Fibrosis regression following hepatitis C antiviral therapy

“…Interestingly, fibrosis regression has been proved to continue as far as years following viral eradication; however, fibrosis regression was mainly documented shortly after end of treatment (EOT) partly due to lack of long term follow up. Several recent studies though could manage to follow HCV patients years following viral eradication to clarify this issue[ 11 , 18 , 23 ].…”