Evolution of Fibrosis, Inflammation, Steatosis and Steatohepatitis in HCV Infected Patients After Treatment With Direct- Acting Antiviral Therapy (A Fibromax® Analysis)

Abstract

Aim: The aim of this study is to assess the evolution of Fibromax® parameters (fibrosis, inflammation, steatosis, steatohepatitis) in patients with chronic HCV hepatitis at one year after sustained virologic response (SVR) achieved by direct acting antiviral agents (DAA). Methods: This is a retrospective observational trial including 73 patients with chronic HCV hepatitis, who obtained sustained virologic response under ombitasvir/paritaprevir/ritonavir and dasabuvir, ledipasvir/sofosbuvir or sofosbuvir/velpatasvir. All the patients were evaluated by Fibromax before the initiation of therapy and at 12 months after SVR. Results and Conclusion: The study included 42 women (57.53%) and 31 men (42.46%), without significant difference in mean age or BMI. We found a higher prevalence of patients with minimal or moderate fibrosis (F1, F2), compared to patients with advanced fibrosis (F3) (63.01% versus 10.95%). At one year follow-up, we found an increased number of patients in the lower levels of fibrosis, inflammation and NASH, with a relatively constant distribution of patients regarding steatosis. Necro-inflammatory activity was significantly diminished, with 58 patients in the no to minimal activity, compared to 37 patients before antiviral therapy. More patients presented N0 and N1 degree of NASH at follow-up than before therapy (63 patients versus 42 patients, p= 0.02). The mean values of Fibrotest (p= 0.03), ActiTest (p<0.01) and NashTest (p=0.02) decreased significantly. The mean value of Steatotest also decreased, but without statistical significance (p=0.12).