Fibroscan as Non-Invasive Modality for Studying the Effect of Hepatic Steatosis on Viral Response to Direct-Acting Antiviral in Patients with Chronic Hepatitis C

Abstract

Abstract Background HCV is a major cause of viral hepatitis leading to chronic liver disease and liver failure. With an estimated prevalence of 3% in the world population (around 170 million infected individuals worldwide), HCV heavily burdens public health. Even though the incidence of new infections is declining, at least in industrialized countries where they are restricted to intravenous drug users, morbidity and mortality associated with HCV infection are expected to increase over the next decade. Objectives The aim of this study to the impact of hepatic steatosis on SVR in HCV infected patients receiving DAA therapy. Patients and Methods This prospective observational study was conducted on 40 patients with HCV (anti-hcv seropositive with detectable HCV-RNA). All included patients were subjected to full history taking, thorough clinical examination, full laboratory investigations including: complete blood count, liver profile tests, kidney function tests, lipid profile, abdominal ultrasonography and Transient elastography with controlled attenuation parameter (CAP). Results The total SVR and Non-SVR rates among treated patients were 90% and 10%, respectively. The comparison between SVR and Non-SVR patients through the baseline parameters showed that patients who failed to treatment had significantly higher bilirubin, BMI and ALT. Furthermore, liver function parameters was improved significantly in majority of cases. The Impact of treatment regimens on the liver enzymes indices; transaminases was significantly declines during and after complete treatment. On the other hand, serum albumin level was significantly decreased. Regarding the complete blood count indices we found the HB% level was significantly changed with transient declining during the treatment periods. The WBCs count, PLT count were not significantly changed. Conclusion Hepatic steatosis was common in HCV infection, the overall SVR-12 was 90%, so that, hepatic steatosis has no impact on SVR-12 in patient with HCV infection undergoing DAA therapy. Fibrosis has no impact on SVR-12 as shown by P-value 0.729. BMI has negative impact on SVR-12 as shown by P-value 0.035. Bilirubin has negative impact on SVR-12 as shown by P-value 0.001. ALT has negative impact on SVR-12 as shown by Pvalue 0.009. HSI has no impact on SVR-12 as shown by p-value 0.077.