Liver fibrosis assessment in cases of chronic hepatitis C after direct acting antivirals therapy using aspartate aminotransferase to platelet ratio index and transient elastography

Abstract

Background and study aim: The treatment of chronic hepatitis C infection (CHC) has been revolutionized by using novel direct-acting antivirals (DAAs). Transient elastography (TE) and aspartate aminotransferase to platelet ratio index (APRI) are simple and convenient diagnostic tools for the assessment of liver fibrosis. This study was designed to evaluate liver fibrosis by using TE and APRI before and one year after a full course of DAAs therapy in cases with CHC infection. Patients and methods: TE and APRI were measured before treatment and one year after a full course of DAAs therapy in a prospective study of 82 CHC cases. All candidates with CHC infection were genotype 4. TE was measured by Fibroscan and liver stiffness measurement (LSM) was considered reliable if 10 successful LSM had been obtained with a success rate (SR) ≥ 60% and interquartile range (IQR) <30%. Results: The current study was conducted on 82 subjects of CHC. The median value of liver stiffness measurement was markedly decreased from 10.6 to 6 kPa after 12 months of completion of DAAs therapy (p < 0.05). Significant reduction of fibrosis stages had occurred in 14/16 (87.50%) of patients with F2 stage, 14/16 (87.5%) of patients with F3 stage, and 26/34 (76.5%) of patients with F4 stage (p < 0.001). The Median APRI value was markedly decreased from 1.12 to 0.42 after 12 months of completion of DAAs therapy (p < 0.001). Conclusion: Liver fibrosis evaluated by TE and APRI markedly decreased in patients with CHC infection after DAAs therapy reflecting regression of liver pathology.