Noninvasive assessment of hepatic fibrosis regression in hepatitis C virus-infected patients treated with sofosbuvir-based therapy

Abstract

Background Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial to make therapeutic decisions and to determine the prognosis of liver disease and also the protocol of further follow-up. Multiple noninvasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive parameters of hepatic fibrosis after effective antiviral therapy are still not well unknown. The aim of the paper was to evaluate early changes in the hepatic fibrosis-related parameters in patients with chronic hepatitis C virus (HCV) infection using shear wave elastography (pSWE) and serum parameters [aspartate aminotransferase-platelet ratio index (APRI) and fibrosis-4 score (FIB4)] before and 24 weeks after sofosbuvir-based antiviral therapy. Materials and methods This is a prospective cohort study that included 109 Egyptian patients with chronic hepatitis C. pSWE values were recorded as well as APRI and FIB4 scores were calculated at baseline and at 12 and 24 weeks after treatment. Results A total of 109 HCV-infected patients were included, with mean age of 45.76±13.91 years. Overall, 25 (22.90%) patients had cirrhosis and were treated with sofosbuvir 400 mg/day, daclatasvir 60 mg/day, and weight-based ribavirin. Moreover, 84 (77.10%) were treated with sofosbuvir 400 mg/day and daclatasvir 60 mg/day. The overall sustained virological response-12 rate was 100%. There were significant improvements in APRI score (from 0.64±0.66 at baseline to 0.26±0.22 at 24 weeks after treatment) and FIB4 score (from 1.77±1.77 at baseline to 1.11±1.04 at 24 weeks after treatment), with P value of 0.0001 in both. In addition, there was a significant reduction in liver stiffness measurements by pSWE 24 weeks after treatment (from 1.72±0.55 m/s at baseline to 1.48±0.44 m/s at 24 weeks after treatment, with P=0.003). Conclusion Sofosbuvir-based treatment regimens for chronic HCV infection result in significant improvement of the fibrosis scores (FIB4 and APRI) 24 weeks after treatment. Moreover, there was a significant reduction in the liver stiffness measurements by pSWE.

Keywords

• directly acting antiviral drugs
• hepatitis c virus and hepatic fibrosis regression
• liver stiffness
• sofosbuvir