Abstract

Objective: Non-invasive assessments, i.e., transient elastography (Fibroscan®), FIB-4 (Fibrosis-4) and [AST (aspartate aminotransferase) to platelet ratio index] APRI scores are used to measure liver stiffness during the long term follow up of patients diagnosed with Chronic hepatitis C (CHC). To evaluate the liver stiffness measurements detected by non-invasive methods in CHC patients treated with direct acting antivirals (DAAs) in the long term.

Methods: Liver stiffness measurements carried out with transient elastography, FIB-4, APRI scores, and biochemical data before and after the treatment and during the long-term follow-up of 26 patients with CHC treated with DAAs were reviewed retrospectively. Patients receiving Paritaprevir + Ritonavir/Ombitasvir + Dasabuvir were included in group 1 (n=13), and patients receiving Sofosbuvir + Ledipasvir ± Ribavirin in group 2 (n=13).

Results: Mean liver stiffness measurement of the patients was 15.50±2.13 kPa (min-max: 5.20-45.00 kPa) before treatment, 12.15±1.84 kPa (min-max: 4.30-42.00 kPa) at the end of treatment and 9.73±1.57kPa (min-max: 3.0-42.2 kPa) at 28 months after the treatment. Significant regressions were also seen in the APRI and FIB-4 scores of patients during the long term follow up treatment compared to baseline (APRI at the onset of treatment: 0.79±0.62, APRI during the long term follow-up: 0.25±0.13, p<0.01; FIB-4 at the onset of treatment: 2.65±1.82, FIB-4 during the long term follow up: 1.66±1.23, p<0.01).

Conclusion: Significant improvements were seen in the stage of fibrosis in the long-term follow-up of the treatment with current antiviral therapies.