Comparison between Size of OV, Fibroscan in Chronic Hepatitis C Patients before & after Treatment with DAAs

Abstract

Abstract Background HCV infection is a global health issue and one of the major causes of chronic liver diseases, Egypt on the top of the countries with heavy HCV burden, HCV genotype 4 is the most common in Egypt and represents 92% of total infections. Objective To asses changes on the size of esophageal varices and liver stiffness after treatment of HCV with DAAs. Patients and Methods The study was carried out at Gastroenterology and hepatology Department, Ain-Shams Hospital and Kobry-Elkoba Military Hospital and included 60 patients with chronic infection of hepatitis c virus diagnosed by (HCV Ab by ELISA positive and HCV RNA by PCR positive) and was divided into 3 groups: Group I: 20 patients chronically infected with HCV received sofosbuvir (one 400 mg tablet taken once daily) & Ribavirin (weight –related dose, 75 kg or less: 400 mg orally in the morning and 600 mg in the evening, Greater than 75 g: 600 mg orally twice daily and decrease the dose in case of anaemia) for 6 months. Group II: 20 Patients chronically infected with HCV received sofosbuvir (one 400 mg tablet taken once daily) & simeprevir (one 150 mg tab taken once daily) for 3 months. Group III: 20 patients chronically infected with HCV received sofosbuvir (one 400 mg tablet taken once daily with or without food) & daclatasvir (one 60 mg tab taken once daily) for 3 months. Results In the study, patients achieved high rates of SVR 12 (98.3%) only one patient at group II relapsed after finishing the treatment and did not reach SVR12. In the study, there was decrease in fibroscan stages after treatment with different regmins of DAAs, but it was significant with group III (HCV patients who received sofosbuvir & daclatasvir for 3 months). In the study, There is significant improvement in liver enzymes (AST&ALT) and significant increase at platelet count after treatment in all the 3 groups, Also there was significant decrease in hemoglobin level in group I (SOF/RIB) in comparison to other groups. In the study, there was no significant change in OV grading in group I before and after treatment, and also in group II & III only one patient in each group had changes in OV grading after treatment from OV grade III to OV grade II. Conclusion High rates of SVR achieved after DAAs therapy associated with significant improvement of the liver function and fibrosis regression estimated by (LSM by fibroscan) but with no improvement of the degree of esophageal varices at least in short term follow up after therapy.