Background and study aims: Liver biopsy is the standard method to assess hepatic fibrosis, but it is unpractical as it is invasive ‎and not agreed by most patients. So, many non-invasive methods for evaluating liver fibrosis ‎have been used including fibrosis-4 (Fib-4) score. We aimed to evaluate hepatic fibrosis changes ‎in patients with chronic hepatitis C after directly acting antiviral therapy.‎
Patients and Methods: ‎‎‎ ‎162 chronic hepatitis C patients were given directly acting anti-viral drugs (DAAs): sofosbuvir ‎‎(400 mg/d) plus daclatasvir (60 mg/d), with or without Ribavirin (600 mg/d) for 12 weeks. Liver ‎fibrosis was assessed before and 48 weeks after end of treatment (EOT) through evaluation of: 1- ‎Serum tissue inhibitor of metalloproteinases-1 (TIMP-1), 2- Liver fibrosis score (Fib-4 score), 3- ‎Liver stiffness measurement (LSM) using Shear Wave Elastography (SWE)‎.‎
Results: sustained virological response was achieved in 95.1% of cases at 48 weeks after EOT. Liver ‎fibrosis was improved at 48 weeks after EOT as evidenced by significant decline in serum level of ‎TIMP-1, significant improvement in Fib-4 score, and significant decline in LSM values using ‎SWE. Multivariate regression analysis showed that higher baseline ALT level and higher ‎baseline liver fibrosis score were predictive of liver stiffness.
Conclusion:DAAs therapy showed not only high success rate in HCV eradication (95.1%), ‎but also lead to significant improvement in liver fibrosis‎ ‎‎‎‎‎‎‎‎.