Evaluation of Direct-Acting Antiviral Therapy Efficacy and Post-Treatment Fibrosis with Noninvasive Markers in Patients with Chronic Hepatitis C

Abstract

Introduction: Hepatitis C virus (HCV) infection is an important cause of chronic liver disease. Monitoring liver fibrosis status plays a crucial role in the surveillance and management of patients undergoing treatment with Direct-acting antiviral agents (DAAs). Aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) index are non-invasive methods that can be used in the evaluation of liver fibrosis. In this study, it was aimed to evaluate the efficacy of the treatment and side effects of new DAAs and to compare APRI and FIB-4 scores before and after treatment. Materials and Methods: One hundred thirteen patients were included in the study. The selection of the treatment regimen was based on factors including the virus genotype and patient-related considerations, such as the presence of cirrhosis and prior treatment history. HCV-RNA, hemogram, ALT, and AST values were documented at the 1st and 3rd months during the treatment course (for those with a six-month treatment duration, measurements were also taken at the end of the 6th month). Additionally, assessments were conducted at the 3rd, 6th, and 12th months post-treatment to evaluate treatment response. APRI and FIB-4 scores were recorded before and after treatment. Results: The mean age of the patients was 52 years with 51.3% (58) being female and 48.7% (55) male. Among the patients, 53.1% (60) were treatment naïve. The most common genotype was genotype 1b, found in 47.8% (54) of the patients. 21.2% (24) of the patients had comorbidities. The most common comorbidity was hypertension (n= 14). The sustained virological response rate after DAA treatment was found to be 100%. At the end of the treatment, the mean ALT and AST values, as well as the mean APRI and FIB-4 scores, were significantly lower than their baseline levels. Conclusion: DAAs can be safely used thanks to their high efficacy and minimal side-effect profile. Additionally, noninvasive methods like APRI and FIB-4 can be valuable in assessing liver fibrosis.

Keywords

• apri
• fib-4
• hepatitis c
• direct-acting antiviral