The Effect of Direct Acting Antiviral Therapy for Hepatitis C- Virus Infected Egyptian Patients on Changes in the Parameters of Liver Fibrosis Progression

Abstract

Hepatitis C Virus (HCV) is a major health care concern worldwide. Egypt shows the highest worldwide HCV prevalence. Fibrosis progression is common in HCV and it is the most important prognostic factor in chronic HCV patients. The aim of this study was to investigate changes in some parameters of liver fibrosis progression after successful HCV eradication by direct acting antiviral (DAA) therapy in Egyptian patients. The study included 100 chronic HCV patients. liver stiffness measurement (LSM) was obtained by Transient elastography (TE) or Fibroscan before starting DAA treatment, after the end of 12 weeks of treatment and after achieving sustained virologic response12 (SVR12). Based on baseline LSM, patients were stratified into F2, F3 and F4 groups (METAVIR), F0-F1 patients were excluded. LSM and laboratory data after the end of treatment and after achieving SVR12 was compared with that baseline values in each fibrosis group. Following DAA treatment, all patients achieved SVR12. Mean baseline LSM dropped from 13.5 to 10.1 (kPa) post SVR12; the maximum change occurred in F2 patients 84.3% versus 84.2%, 43.3% in F3, and F4 patients respectively (p < 0.001). At baseline, 30 patients were in the F4 group; only 11 patients (43.3%) regressed to non-cirrhotic range (<12.5 kPa), while 19 patients (56.7%) were still cirrhotic despite achieving SVR12 (p < 0.001). Patients showed significant improvement in platelets count and decreased ALT enzyme levels after achieving SVR12 (p < 0.001). So, successful eradication of HCV results in significant LSM improvement; the best improvement occurs in F2 and F3 patients.