Effect of Successful Direct Acting Antivirals Therapy on Liver Stiffness in Patients with Chronic HCV Infection

Abstract

Background: Achievement of sustained virological response [SVR] and improvement of hepatic fibrosis are the essential goals for therapy of chronic hepatitis C [CHC] with direct acting antivirals [DAAs] therapy. Early detection and management of hepatic fibrosis can significantly improve the prognosis of CHC in clinical practice. Aim of the work: To assess the effect of successful DAAs therapy on liver stiffness in patients with CHC. Methods: This study included 100 patients with chronic HCV-related liver disease. All were treated with Sofosbuvir-based regimen for 12 weeks on outpatient base. HCV treatment applied according to the protocol designed by the Egyptian National Committee for Control of Viral Hepatitis. Follow up continued for 12 weeks [after the end of treatment [EOT]] to estimate effect of successful DAAS therapy on liver stiffness using Shear Wave Elastography [SWE], aminotransferase-to platelet ratio index [APRI] and Fib-4 score before initiation of antiviral therapy, at end of treatment [EOT] and 12 weeks after EOT [SVR12]. Results: Platelets significantly increased, ALT and AST significantly decreased and mean values of APRI, Fib-4 score and Liver stiffness assessment were significantly reduced in all patients at SVR12. Hemoglobin levels significantly reduced in patients receiving ribavirin 12 weeks after EOT. Conclusions: Elimination of HCV after successful DAAS treatment was associated with a significant improvement of the liver stiffness at both EOT and 12 weeks afterwards EOT as evidenced by SWE, Fib-4 score and APRI index.

Non-invasive Evaluation of Liver Fibrosis Changes in Patients with Chronic ‎Hepatitis C after Directly Acting Antiviral Drugs

“…Similarly, Lee SH, 2020, who studied 68 patients with chronic HCV infection and reported that SWE findings showed significant improvement in LSM after 12-week SVR [22]. Also, Serkan et al, 2020, and Ezzelregal, 2020, found a significant regression in the LSM of CHC patients receiving DAA therapy using SWE that carried out at the start of treatment, EOT, and 12 weeks after EOT [23,24]. On the other hand, Ekaterinea et al, 2017, evaluated the effect of DAA therapy on liver fibrosis regression measured by transient elastography in CHC patients and reported decline in the median liver stiffness at week 24 after treatment compared with baseline but despite decreased LS, more than half of the cirrhotic patients with LS remained cirrhotic at week 24 following treatment [25].…”