Serial changes in liver stiffness and controlled attenuation parameter following direct‐acting antiviral therapy against hepatitis C virus genotype 1b. Issue 2 (25th September 2017) - Ogasawara, Nobuhiko
Abstract : Little information is available on the impact of direct‐acting antiviral (DAA) therapy on changes in liver fibrosis and steatosis. Liver stiffness (LS) and controlled attenuation parameter (CAP) values were evaluated using transient elastography. The study subjects were 214 elderly patients infected with HCV genotype 1b who received 24‐week daclatasvir and asunaprevir dual therapy. All patients of this retrospective study had no hepatocellular carcinoma before and during DAA therapy. LS and CAP were assessed before treatment (baseline), at end of treatment (EOT), and at 24, 48, 72 weeks (W) after EOT. The rate of sustained viral response (SVR) by daclatasvir and asunaprevir therapy was 91%. LS values for the entire group correlated with Fib‐4 index at baseline ( r = 0.565, P < 0.001). LS in both chronic hepatitis group (Fib‐4 index <3.25) and cirrhosis group (Fib‐4 index ≥3.25) decreased significantly at each time point compared with baseline ( P < 0.001). Especially, a larger decrease in LS from baseline to EOT was seen in the cirrhosis group than chronic hepatitis group ( P < 0.001). LS was also significantly lower in the SVR group at EOT, 24W, 48W, 72W compared with baseline ( P < 0.001). Even in the non‐SVR group, LS tended to be lower at EOT ( P = 0.039), 24W ( P = 0.009), 48W ( P = 0.475), 72W ( P = 0.033) compared with baseline. CAP increased significantly following the treatment from baseline to 48W post‐EOT ( P = 0.018). Our results showed significant improvement in LS in response to daclatasvir and asunaprevir dual therapy. In the other hand, there was a tendency that CAP increased from baseline.