Publication

DAA treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers FIB-4 and APRI

Journal Paper/Review - Sep 28, 2016

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PubMed
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Citation
Bachofner J, Mullhaupt B, Terziroli Beretta-Piccoli B, Magenta L, Semela D, Fehr J, Moncsek A, Seifert B, Braun D, Baserga A, Künzler-Heule P, Bergamin I, Kröger A, Valli P, Mertens J. DAA treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers FIB-4 and APRI. Liver Int 2016
Type
Journal Paper/Review (English)
Journal
Liver Int 2016
Publication Date
Sep 28, 2016
Issn Electronic
1478-3231
Brief description/objective

BACKGROUND
Novel direct antiviral agents (DAA) targeting hepatitis C virus (HCV) have revolutionized the treatment of chronic hepatitis C infection (CHC). Rates of sustained virological response (SVR) to treatment have drastically improved since introduction of DAA. Transient Elastography (TE) is an ultrasound based, non-invasive technique to assess liver stiffness (LS). We examined the changes in TE values and fibrosis scores FIB-4 and APRI after DAA treatment of CHC.

METHODS
549 patients who received a DAA based treatment for CHC were screened and 392 were included. TE values recorded prior to therapy and within 18 months after therapy were evaluated. In addition, FIB-4 and APRI scores were calculated and histological results were recorded if available.

RESULTS
Median TE prior to DAA treatment was 12.65 kPa (IQR 9.45 - 19.2 kPa) and decreased to 8.55 kPa (IQR 5.93 - 15.25) post-treatment. This finding is statistically significant (p < 0.001) and equals a TE regression of 32.41% after DAA treatment. Median FIB-4 and APRI values significantly decreased from 2.54 (IQR 1.65-4.43) and 1.10 (IQR 0.65-2.43) to 1.80 (IQR 1.23-2.84, p < 0.001) and 0.43 (IQR 0.3-0.79, p < 0.001), respectively.

CONCLUSION
Patients with SVR after DAA therapy showed significant regression of TE values. Rapid decrease of TE was in concordance with regression of validated fibrosis scores FIB-4 and APRI. It remains to be examined whether this indicates a regression of fibrosis or merely resolution of chronic liver inflammation with subsequent improvement of TE values and laboratory parameters. This article is protected by copyright. All rights reserved.