Long-term Follow-up of Chronic Hepatitis C Patients Treated by Direct- Acting Antivirals

Abstract

Background: Hepatitis C virus HCV infection is one of the main causes of chronic liver disease worldwide, Egypt has the highest national-level HCV prevalence in the world, and direct Acting Antivirals are widely used to treat HCV infection in Egypt. Aim: To perform a long-term follow-up of patients with chronic hepatitis C who received IFN free regimen of directacting antivirals (DAAs). The follow-up aimed to study the incidence of hepatocellular carcinoma, viral recurrence in this cohort of patients and improvement of liver biochemicals or liver decompensation. Methodology: We recruited 1041 Egyptian HCV patients, who finished treatment more than 1 year before recruitment and then we assessed the improvement of the biochemical profile and the liver condition, incidence of occurrence or recurrence hepatocellular carcinoma after treatment. Results: The follow-up values of ALT, AST, INR, Bilirubin, Platelets and fibrosis-4 (Fib-4) showed a statistically significant improvement more than 1 year after treatment, while the improvement in albumin and AFP was noted without statistical significancy. By comparing the different groups of the study, patients with advanced liver disease showed a greater improvement in those parameters. However, they carried an increased risk of developing hepatocellular carcinoma. Conclusion: Achieving SVR using DAAs can improve liver functions tests, AFP, platelet count and FIB-4 value and persons with severe liver disease should be advised to undergo HCC surveillance after achieving sustained virological response (SVR).