Abstract
The clinical significance of mac-2 binding protein glycosylation isomer (M2BPGi) levels based on virological responses due to antiviral therapy has not been fully evaluated. We compared the change before and 24 weeks after the therapy with daclatasvir and asunaprevir (DCV+ASV) of M2BPGi levels with those of other fibrosis markers in 73 chronic hepatitis C cases. Moreover, we examined the association between M2BPGi levels and hepatocarcinogenesis in sustained virological response (SVR) and non-SVR cases. M2BPGi levels were significantly improved at post-treatment week 24 (PTW24) in SVR but not non-SVR cases, whereas the changes of other fibrosis markers showed the same tendency in both SVR and non-SVR cases. M2BPGi levels were well correlated with other fibrosis markers at baseline but not PTW24. The incidence of hepatocellular carcinoma (HCC) was significantly associated with M2BPGi levels at PTW24. The achievement of SVR significantly affected the improvement of M2BPGi levels that best reflected the effect of direct-acting antivirals among the fibrosis markers. Furthermore, M2BPGi levels at PTW24 were also associated with the incidence of HCC in only SVR cases. However, the rapid decrease of M2BPGi levels might reflect the amelioration of liver inflammation rather than the improvement of liver fibrosis, which should be further elucidated.
Highlights
We examined whether the association between mac-2 binding protein glycosylation isomer (M2BPGi) levels and development of hepatocellular carcinoma (HCC) after the combination therapy with daclatasvir and asunaprevir (DCV+ASV) was affected by virological responses in those cases
There were no significant differences of age, sex, the rates of liver cirrhosis, the rates of patients with HCC history, pretreatment platelet count, serum total bilirubin (T-bil), AST, ALT, Alb, AFP, hepatitis C virus (HCV) RNA, M2BPGi levels, APRI, FIB-4 index, and resistance-associated substitutions between sustained virological response (SVR) cases and non-SVR cases
M2BPGi levels best reflected the effect of direct-acting antivirals (DAAs)-based therapy among these fibrosis markers
Summary
Japan Society of Hepatology (JSH) guideline for the management of DAA-naïve CHC without decompensated liver cirrhosis, combination therapies with sofosbuvir and ledipasvir (SOF/LDV), elbasvir and grazoprevir (EBR+GZR), glecaprevir and pibrentasvir (GLE/PIB) for genotype 1, and SOF and ribavirin (SOF+RBV), SOF/LDV, and GLE/PIB for genotype 2 have been recommended as the 1st line treatments, respectively. With these therapies, hepatitis C virus (HCV) eradications are possible in over 95% among treatment naïve patients [1,2,3,4,5,6]
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