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Changes in Liver Steatosis as Well as Liver Fibrosis in Patients with Chronic Hepatitis C After Successful Direct-Acting Antiviral Therapy
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  • Anahita Sadeghi,
  • Roya Amiri,
  • Elham Akbarpour,
  • Babak Mirminachi,
  • Amir-Houshang Sharifi,
  • Shahin Merat
Anahita Sadeghi
Tehran University of Medical Sciences
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Roya Amiri
Tehran University of Medical Sciences
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Elham Akbarpour
Tehran University of Medical Sciences
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Babak Mirminachi
Tehran University of Medical Sciences
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Amir-Houshang Sharifi
Tehran University of Medical Sciences
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Shahin Merat
Tehran University of Medical Sciences
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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.

Peer review status:UNDER REVIEW

06 Sep 2020Submitted to International Journal of Clinical Practice
08 Sep 2020Assigned to Editor
08 Sep 2020Submission Checks Completed
17 Sep 2020Reviewer(s) Assigned