Changes in Liver Steatosis as Well as Liver Fibrosis in Patients with
Chronic Hepatitis C After Successful Direct-Acting Antiviral Therapy
Abstract
Introduction and Objectives: After successful treatment of hepatitis C
virus (HCV) infection with direct-acting antivirals (DAAs), the stage of
liver fibrosis decreases by time. Here, we aimed to assess the changes
in liver fibrosis stage using transient elastography (TE) after
successful DAA therapy in HCV-infected cirrhotic patients who referred
to Shariati hospital from 2016 to 2017. Material and Methods: In this
observational cohort, all HCV-infected cirrhotic patients who were
treated with a combination of sofosbuvir/daclatasvir and had achieved
sustained virologic response (SVR) and also had undergone pre- and
post-treatment TE, were enrolled. The primary outcome was the changes in
TE parameters six months after the end of treatment compared to
baseline. Results: A total of 442 eligible subjects received DAA
therapy. Overall, the SVR rate was 96.6%. Of these, 149 patients had
completed the protocol and were enrolled. The mean age of patients was
56.1±10.3 years and the predominant sex was male (77.9%). The median
(Q1-Q3) liver stiffness (LS) value at baseline was 26.3 kPa (18.1-38
kPa), which significantly decreased to 20.9 kPa (12-29.7 kPa) [z =
-8.45, p-value < 0.001]. Also, the liver steatosis of
patients with baseline CAP ≥ 220 dB/m had a significant response to
treatment [z = -2.3, p-value = 0.023]. Based on multivariate
analysis, a higher baseline liver fibrosis stage was the only
determinant of LS values improvement in our study. Conclusion:
Successful HCV eradication in patients with liver fibrosis results in
significant improvement in LS, even in cirrhotic patients.