THE EVOLUTION OF LIVER FIBROSIS AFTER THE TREATMENT WITH DIRECT-ACTING ANTIVIRAL AGENTS IN HEPATIC CIRRHOSIS: EXPERIENCE OF A CENTER

Abstract

Objectives. Liver fibrosis is a prognostic marker of the evolution of hepatitis C virus infection, and imaging investigations are important in diagnosing and assessing the severity and progression of fibrosis. The purpose of the study was to evaluate the efficacy of direct-acting antiviral agents with/without Ribavirin, in patients with cirrhosis with hepatitis C virus and progression of liver fibrosis after treatment. Materials and methods. The study included 75 patients with cirrhosis with hepatitis C virus, divided into two groups, according to duration and treatment regimen: group I – Sofosbuvir and Daclatasvir/Ledipasvir with Ribavirin, for 12 weeks, group II – Sofosbuvir and Daclatasvir/Ledipasvir, for 24 weeks. Results. The distribution of patients, according to the fibrosis stage assessed by Fibroscan, was: stage F3 in 6 (8%) patients, stage F4 – 69 (92%) patients. In group I, the mean value of liver fibrosis, at the initiation of antiviral therapy, at 6 and 12 months after treatment, was 31 ± 14.0 kPa, 25.3 ± 10.7 kPa and 20.3 ± 10.1 kPa, respectively; in group II, the mean value of liver fibrosis was 28.5 ± 10.0 kPa, 28.2 ± 11.6 kPa and 24.3 ± 10.1 kPa, respectively. The biochemical response was obtained in both groups, the transaminase profile being improve at the end of the treatment. Sustained virologic response was present in 69 (92%) patients. Treatment failure was observed in 6 (8%) patients. Conclusions. Direct-acting antiviral therapy have shown high rates of sustained virological response in patients with hepatic cirrhosis, and the results of our study revealed an improvement in liver fibrosis, after this treatment.

Keywords

• Cirrhosis
• Fibrosis
• Daclatasvir
• Ledipasvir
• Sofosbuvir
• Ribavirin