Background: There is some debate about the effect of direct-acting antiviral regimens (DAAs) on regression of liver fibrosis, but no definitive conclusion has been reached. The aim of this study is to evaluate liver stiffness measurement changes after attaining sustained virologic response (SVR) for HCV following DAAs treatment using non-invasive methods.
Methods: This retrospective study analyzed 84 patients with chronic HCV infection who were treated with DAAs and achieved SVR after treatment. At baseline and 24 weeks post sustained virologic response (SVR24), transient elastography values were obtained and the Fibrosis-4 score (FIB-4) and AST to Platelet Ratio Index (APRI) were calculated.
Results: Compared to baseline data, patients achieved SVR following DAAs treatment showed significant decrease in liver stiffness measurement at SVR24 (16.6±12.6 vs 12.6 ± 11.6 kPa) (P<0.01) with significant fibrosis down staging in the majority of patients. Furthermore, there was a significant improvement as regarding, FIB-4 and APRI scores at SVR24 (2.1±1.9 vs 5.1 ± 2.3 and 0.33 ± 0.2 vs 0.93 ± 0.4 respectively, P <0.001).
Conclusion: DAAs treatment significantly improved liver stiffness as measured by FibroScan. Further, multicenter prospective studies with histopathologic correlations are needed to clarify the impact of DAAs on the improvement of necroinflammation and fibrosis.