The Effect of HCV Eradication after Direct Acting Antiviral Agents on Hepatic Steatosis: A Prospective Observational Study

2021 ◽  
Vol 21 ◽  
Author(s):  
Hanan Soliman ◽  
Dina Ziada ◽  
Manal Hamisa ◽  
Rehab Badawi ◽  
Nehad Hawash ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Transient Elastography ◽  
Antiviral Agents ◽  
Liver Stiffness ◽  
Direct Acting Antiviral ◽  
Egyptian Patients ◽  
Fibrosis Regression ◽  
One Year ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

Background and Aims: Eradication of hepatitis C virus (HCV) by direct-acting-antiviral-agents (DAAs) was followed by fibrosis regression, but little is available about hepatic steatosis changes after DAAs. The aim of this work was to assess the prevalence of hepatic steatosis among HCV Egyptian patients and the long term changes occur after viral eradication. Methods: This prospective cohort study included 150 HCV patients with significant fibrosis. They were examined by Transient elastography to evaluate liver stiffness measurement (LSM) and hepatic steatosis before treatment, at SVR12 and 1 year after end of therapy. Results: LSM showed significant positive correlation to pretreatment hepatic steatosis. LSM significantly decreased and hepatic steatosis significantly increased both at SVR12 and one year after DAAs. Patients with steatosis showed significantly higher median LSM and controlled attenuation parameter (CAP) values at: baseline, SVR12, and one year after therapy. Also, the pretreatment steatosis and body mass index (BMI) had significant negative correlation with fibrosis regression one year after therapy in all studied groups. Conclusion: Hepatic steatosis is common in HCV Egyptian patients and increases after HCV eradication with DAAs. BMI and CAP values are negatively correlated to hepatic fibrosis regression and positively correlated to steatosis progression one year after DAAs. So, HCV patients with hepatic steatosis may need close follow up for atherosclerotic and HCC risk after DAAs especially if they are overweight.

Predictors for Fibrosis Regression in Chronic HCV Patients after the Treatment with DAAS: Results of a Real-world Cohort Study

2020 ◽  
Vol 20 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Hanan Soliman ◽  
Dina Ziada ◽  
Marwa Salama ◽  
Manal Hamisa ◽  
Rehab Badawi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Virologic Response ◽  
Factors Affecting ◽  
Observational Cohort ◽  
Fibrosis Regression ◽  
One Year ◽  
Chronic Hcv ◽  
Direct Acting

Introduction: The goal of treatment of chronic hepatitis C (HCV) is viral eradication. However, obtaining histological regression is even more important, because it will reduce the overall morbidity and mortality related to cirrhosis. Introduction of direct-acting antivirals (DAAs) in HCV improves rates of sustained virologic response (SVR). However, fibrosis regression has not been extensively assessed. The aim of this study was to detect the factors affecting fibrosis regression in chronic HCV patients treated with interferon containing regimens versus interferon-free DAA regimens. Methods: This prospective observational cohort study was conducted at the Tropical Medicine and Infectious Diseases Department, Tanta University, Egypt, between October 2015 and December 2017. Transient elastography (FibroScan®) examination was performed before therapy, at SVR12, 6 months and 1 year after completing therapy for cured patients. Results: Reduction in fibrosis was reported in; 46.7% and 49.3% of patients with moderate fibrosis, and 89% and 78.7% of patients with advanced fibrosis after one year of interferon containing and interferon free DAAs regimens respectively. Using multiple regression analysis; it was found that BMI, degrees of hepatic stiffness and steatosis were related to regression of hepatic fibrosis after therapy. Conclusion: DAAs with or without interferon resulted in a significant reduction of liver fibrosis. BMI, steatosis and liver stiffness were independent factors for fibrosis regression in chronic HCV patients treated with DAAs. Further studies are needed to explore the mechanism by which steatosis affects HCV related fibrosis regression after treatment with DAAs.

scholarly journals Angiopoietin-2 as a predictor of fibrosis regression in chronic hepatitis C virus patients after direct-acting antiviral drugs

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Amira Isaac ◽  
Tarek Maged El Sakaty ◽  
Sarah Hamdan Hussein ◽  
Hany Samir Rasmy
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Disease Progression ◽  
Antiviral Agents ◽  
Direct Acting Antiviral ◽  
Fibrosis Regression ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Angiopoietin 2 ◽  
Direct Acting Antiviral Agents

Abstract Background HCV infection is a major health concern. Disease progression to fibrosis, cirrhosis, and HCC is aided by the persistence of inflammatory reactions and cellular damage. Moreover, angiogenesis was found to have a substantial pathogenic role in disease progression. Serum Angiopoietin-2 appears to be correlated with liver stiffness in chronic HCV and its elevation is linked to disease progression from chronic hepatitis to cirrhosis. The aim of this study was to evaluate the role of serum Angiopoietin-2 in the prediction of regression of fibrosis in chronic HCV patients receiving direct-acting antiviral agents. Forty Egyptian chronic HCV patients for whom direct-acting antiviral agent (DAA) therapy was planned were included. All patients underwent assessment twice, at baseline and at SVR12, for standard laboratory tests, measurement of fibrosis using FibroScan, FIB-4 and APRI scores, and Angiopoietin-2 level. Results Statistically significantly higher levels of baseline Ang-2 were detected with the progression of fibrosis stages with a p-value of <0.001. The best cutoff value of baseline Ang-2 in discrimination of liver cirrhosis (F4) from F0-F3 was > 630 pg/ml with 85.71% sensitivity and 84.85% specificity. A statistically significant decline of Ang-2 (from 464.3±237.2 pg/ml to 401.3±277.1 pg/ml) was noted after the achievement of SVR12 with a p-value < 0.001. Regression of liver fibrosis in this study is defined as a decrease of more than or equal to one stage in liver fibrosis. Lower baseline fibrosis stages and other non-invasive scoring systems (FIB-4 and APRI scores) were associated with regression of fibrosis following successful DAAs treatment. However, higher baseline Ang-2 levels were significantly associated with non-regression of fibrosis, and at a cutoff of >680 pg/ml, it might predict non-regression of fibrosis after successful eradication of HCV with DAAs with 93.33% sensitivity and 70% specificity. Conclusions Angiopoietin-2 can be a useful predictor of fibrosis regression in chronic HCV patients receiving direct-acting antiviral agents. Elevated baseline Angiopoietin-2 and advanced fibrosis stages may predict non-regression of liver fibrosis.

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