IDDF2022-ABS-0181 Combination of post-daa liver fibrosis and neutrophil-to-lymphocyte ratio predicts the development of liver-associated complications in chronic hepatitis C patients who achieve sustained virologic response. (2nd September 2022)

• Record Type: Journal Article
• Authors: Hong, Chun-Ming; Su, Tung-Hung; Tseng, Tai-Chung; Hsu, Shih-Jer; Liu, Chen-Hua; Yang, Hung-Chih; Kao, Jia-Horng; Chen, Pei-Jer; Yu, Ming-Lung
• Is Part Of: Gut. Volume 71(2022)Supplement 2
• Page Start: A90
• Page End: A90
• Publication Date: 2022-09-02
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-IDDF.113
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Direct-acting antiviral agents (DAAs) can achieve high sustained virologic response (SVR) in chronic hepatitis C (CHC) patients; yet a proportion of patients still experience liver-associated complications after SVR. Identification of prediction factors is clinically important. FIB-4 index is a useful noninvasive tool to assess fibrosis. Besides, neutrophil-to-lymphocyte ratio (NLR) is a biomarker for systemic inflammation. Our aim is to investigate the association between the combination of post-SVR Fib-4 with NLR and liver-associated complications in post-SVR CHC patients. Methods: We recruited patients via The Taiwan HCV Registry. The inclusion criteria were patients who were followed at least 24 months after SVR12. Results: Totally 2093 patients were enrolled from 2017/01/01 to 2019/12/31. 412 patients (19.7%) were cirrhotic and 295 (14.1%) had prior treatment. 1018 patients (48.7%) were infected with genotype 1, followed by genotype 2 (39.3%). Sofosbuvir/ledipasvir, glecaprevir/pibrentasvir, and elbasvir/grazoprevir were the main DAA regimens. 25 patients developed HCC, ascites, variceal bleeding, or spontaneous bacterial peritonitis. Among these 25 patients, 22 patients (88.0%) were cirrhotic at baseline and 17 patients (68%) had Fib-4> 3.25 after SVR 12. 21 patients with combined FIB-4> 3.25 and NLR>4 had higher incidence of de novo liver-associated complications (9.5%) than the 1687 patients with combined FIB-4< 3.25 and NLR<4 (0.5%) (IDDF2022-ABS-0181 Table 1). Conclusions: The overall incidence of de novo hepatocellular carcinoma, ascites, variceal bleeding, or spontaneous bacterial peritonitis is low during short-term follow-up after HCV eradication. A combination of post-SVR FIB-4 and NLR is a useful indicator for liver-associated complications in this group of patients.