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Noninvasive Measurements Predict Liver Fibrosis Well in Hepatitis C Virus Patients After Direct-Acting Antiviral Therapy

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Abstract

Background

Short-time usage of direct-acting antiviral agents (DAA) limited knowledge regarding histological outcomes and predictive values of noninvasive measurements in patients with hepatitis C virus (HCV) after sustained virologic response (SVR) with DAA.

Aims

This study aimed to indicate histological changes and assess predictive value of noninvasive measurements for fibrosis in these patients.

Methods

HCV patients who achieved SVR by DAA were identified. Pre- and post-SVR clinical and histological data were collected.

Results

Of patients, 83% (33/40), 38% (15/40) and 83% (33/40) achieved inflammation improvement, fibrosis regression and histological improvement, respectively. Liver stiffness measurements (LSM), APRI, and FIB-4 could predict post-SVR fibrosis well without significant differences. Areas under receiver operating characteristic curves of LSM, APRI, and FIB-4 were 0.78, 0.81, and 0.87 for post-SVR advanced fibrosis (≥ F4) and 0.86, 0.86, and 0.85 for post-SVR cirrhosis (≥ F5), respectively. Pre-SVR LSM, APRI, and FIB-4 values were significantly lower in patients with fibrosis regression (P = 0.003–0.012), while FIB-4 was significantly lower in patients with histological improvement (P = 0.012–0.033). Patients with higher pre-SVR Ishak scores tended to have bigger decline in APRI (P = 0.025) and FIB-4 (P = 0.024) after SVR.

Conclusions

DAA could improve liver inflammation and fibrosis of HCV patients in a short time after SVR. LSM, APRI, and FIB-4 predict fibrosis well even after SVR by DAA. Most of the cutoff values for advanced fibrosis (≥ F4) and cirrhosis (≥ F5) of these noninvasive measurements decreased significantly after SVR, maybe because of the inflammation improvement.

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Funding

This study was funded by National Natural Science Foundation of China [Grant Number: 81870406], China National Science and Technology Major Project for Infectious Diseases Control during the 13th Five-Year Plan Period [Grant Number: 2017ZX10202202] and Beijing Natural Science Foundation [Grant Number: 7182174].

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Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Hepatology Institute, Beijing Key Laboratory for Hepatitis C and Immunotherapy for Liver Disease, No. 11 Xizhimen South Street, Beijing, 100044, China

    Rui Huang, Huiying Rao, Ming Yang, Yinghui Gao, Jian Wang, Qian Jin, Danli Ma & Lai Wei

  2. Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China

    Ming Yang & Lai Wei

Authors
  1. Rui Huang
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  2. Huiying Rao
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  3. Ming Yang
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  5. Jian Wang
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  6. Qian Jin
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  7. Danli Ma
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  8. Lai Wei
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Correspondence to Lai Wei.

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Conflict of interest

Lai Wei has received research support and/or consulting fees from AbbVie, Bristol-Myers Squibb, Roche, Novartis and Gilead, but none are relevant to this particular study. Rui Huang, Huiying Rao, Ming Yang, Yinghui Gao, Jian Wang, Qian Jin, and Danli Ma have no outside support, conflicts, or financial interests to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Huang, R., Rao, H., Yang, M. et al. Noninvasive Measurements Predict Liver Fibrosis Well in Hepatitis C Virus Patients After Direct-Acting Antiviral Therapy. Dig Dis Sci 65, 1491–1500 (2020). https://doi.org/10.1007/s10620-019-05886-y

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