Early fibrosis regression by shear wave elastography after successful direct-acting anti-HCV therapy

  • Mohamed Ahmed Samy KohlaEmail author
  • Ahmed El Fayoumi
  • Mohamed Akl
  • Mervat Abdelkareem
  • Mahmoud Elsakhawy
  • Sally Waheed
  • Mai Abozeid
Original Article


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.


Liver 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.

Authors’ contribution

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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Hepatology and Gastroenterology, National Liver InstituteMenoufia UniversityShebin El-KomEgypt
  2. 2.Department of Diagnostic and Interventional Radiology and Medical Imaging, National Liver InstituteMenoufia UniversityShebin El-KomEgypt
  3. 3.Department of Epidemiology and Preventive Medicine, National Liver InstituteMenoufia UniversityShebin El-KomEgypt

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