Short-term changes of liver fibrosis in patients with HCV genotype 1b – related compensated cirrhosis after sustained virologic response

Abstract

Several studies suggested a regression of liver fibrosis (LF) over time after successful therapy in HCV infected patients. The aim of this study was to assess the changes of fibrosis occurring after successful direct acting antiviral (DAA) treatment using transient elastography (TE) and FIB-4 score in patients with HCV genotype 1 b compensated cirrhosis. Material and methods: LF were evaluated by TE and FIB-4 at baseline, sustained virological response (SVR) and 12 months after end of treatment (EOT). LF regression was defined as an improvement of ≥ 30% in Fibroscan® score at follow-up compared to baseline. Results: There were 98 patients with HCV-related compensated liver cirrhosis who achieved SVR after DAAs, most female (65.3%), aged 60.64 ± 9.56 years. Overall, LF had a significant improvement with a median (IQR) regression of 4.5 (1.8-7.8) from baseline to SVR and 5.1 (2.5-8.65) from baseline to 12 months after EOT (p <0.001). Also, the FIB-4 score significantly decreased at SVR and 12 months after EOT, similar to LSM values [median (IQR) at SVR 2.27 (1.55-3.26) and 2.21 (1.51-3.28) at 12 months after EOT (p <0.001)]. Conclusions: We demonstrated that achieving SVR with DAA-based regimens was associated with significant improvement of liver stiffness measured by TE, and liver function monitored by FIB-4 index, but the regression of fibrosis must be constantly evaluated in dynamic thus further studies are warranted to confirm these findings in other populations.