Early fibrosis regression by shear wave elastography after successful direct-acting anti-HCV therapy
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Shear wave elastography (SWE) is a noninvasive ultrasound-based marker of hepatic fibrosis not requiring a special device. Successful direct-acting anti-HCV therapy was associated with hepatic fibrosis regression assessed by transient elastography (FibroScan). Data on the utility of SWE in these patients and how early fibrosis can regress after treatment are still lacking. To assess liver fibrosis by SWE before and after direct-acting antiviral treatment of chronic hepatitis C (CHC), we enrolled 165 CHC genotype 4 Egyptian patients treated with different Sofosbuvir-based regimens. Patients’ laboratory characteristics, fibrosis biomarkers, namely Fibrosis-4 (FIB-4) index and AST/platelet ratio index (APRI) and liver stiffness measurements (LSM) by SWE were evaluated at baseline, end of treatment (EOT at week 12), week 24 and week 36. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels as well as FIB-4 and APRI indices decreased significantly at EOT, week 24 and week 36 in comparison to baseline (P value < 0.001). Although platelet counts did not significantly differ between baseline and EOT, they increased significantly from EOT to week 24 and week 36 with a P value < 0.001. The mean LSM showed improvement at EOT (7.01 ± 3.59 kpa), week 24 (6.18 ± 3.39 kpa) and week 36 (5.74 ± 3.21 kpa) in comparison to baseline (8.49 ± 0.83 kpa) (P value < 0.001). There is early liver fibrosis regression at EOT and throughout the time after successful treatment with direct-acting antiviral agents (DAAs). SWE is a feasible, easily applicable noninvasive relatively inexpensive assessment method of liver fibrosis.
KeywordsLiver fibrosis Shear wave elastography Direct-acting antiviral drugs Hepatitis C
We deeply thank the viral hepatitis treatment clinic team at the National liver institute, Menoufia University, Egypt for their help & support.
MASK, MA, MA: Design of the study. AEF, MA, MA, ME: Data Collection. ME, AEF: Procedures (LSM). MASK, MA, SW: Data analysis. MASK, MA, AEF: Manuscript writing. SW, MASK, MA: Revision, editing & rewriting.
Compliance with ethical standards
Conflict of interest
All the authors declare that they have no conflict of interest.
This study was approved by the institutional review board of the National Liver Institute, Menoufia University and was conducted in compliance with the Declaration of Helsinki.
Informed consent was obtained from all individual participants included in the study.
- 4.Refaat B, Ashshi AM, El-Shemi AG, AlZanbagi A. Effects of chronic hepatitis C genotype 1 and 4 on serum activins and follistatin in treatment naïve patients and their correlations with interleukin-6, tumour necrosis factor-α, viral load and liver damage. Clin Exp Med. 2015;15:293–302.CrossRefGoogle Scholar
- 10.Ragazzo TG, Paranagua-Vezozzo D, Lima FR, et al. Accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with liver biopsy in patients with chronic hepatitis C. Clinics (Sao Paulo). 2017;72:516–25.CrossRefGoogle Scholar
- 17.Lu M, Li J, Zhang T, et al. Serum biomarkers indicate long-term reduction in liver fibrosis in patients with sustained virological response to treatment for HCV infection. Clin Gastroenterol Hepatol. 2016;14(1044–55):e3.Google Scholar