The evaluation of liver fibrosis regression in chronic hepatitis C patients after the treatment with direct-acting antiviral agents – A review of the literature

Abstract

The second-generation of direct-acting antiviral agents are the current treatment for chronic viral hepatitis C infection. To evaluate the regression of liver fibrosis in patients receiving this therapy, liver biopsy remains the most accurate method, but the invasiveness of this procedure is its major drawback. Different non-invasive tests have been used to study changes in the stage of liver fibrosis in patients with chronic viral hepatitis treated with the second-generation of direct-acting antiviral agents: liver stiffness measurements (with transient elastography or acoustic radiation force impulse elastography) or different scores that use serum markers to calculate a fibrosis score. We prepared a literature review of the available data regarding the long-term evolution of liver fibrosis after the treatment with direct-acting antiviral agents for chronic viral hepatitis C. Keywords  chronic viral hepatitis C, direct-acting antiviral agents, liver fibrosis Highlights ✓ Transient elastography is the routine investigation for liver fibrosis monitoring in patients with chronic viral hepatitis C treated with direct acting antiviral agents. ✓ The APRI and FIB-4 scores registered the highest decrease between the baseline and the end of the treatment in patients with chronic viral hepatitis C treated with direct acting antiviral agents.