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Abstract Details
Fibrosis improvement in patients with HCV treated with direct-acting antivirals
James McPhail1, Omar T Sims23456, Yuqi Guo7, David Wooten1, John S Herndon1, Omar I Massoud8
Author information
1Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham.
2Department of Social Work, College of Arts and Sciences.
3Department of Health Behavior, School of Public Health.
4Center for AIDS Research, School of Medicine.
5Integrative Center for Aging Research, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
6Department of Medicine, Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, California.
7Department of Social Work, College of Health and Human Services, University of North Carolina Charlotte, Charlotte, North Carolina.
8Division of Gastroenterology and Hepatology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Abstract
Background and aim: More prospective studies are needed to characterize fibrosis improvement in patients with hepatitis C virus (HCV) who are treated with direct-acting antivirals (DAAs). The aims of this study were to assess changes in elastography scores from baseline to 1-year follow-up in patients with HCV, to identify factors that were independently associated with improvement in fibrosis staging in patients who receive treatment, and to identify factors that were independently associated with no improvement in fibrosis staging among patients who achieved sustained virologic responses (SVR).
Methods: Ultrasound elastography and laboratory tests were performed and collected at baseline and at 1-year follow-up for patients who received HCV treatment and for those who did not receive treatment (n = 240). Binomial logistic regression was used to examine factors that were independently associated with improvement in fibrosis staging.
Results: In patients who achieved SVR, the mean fibrosis score decreased significantly (-1.3) from 7.4 (2.3) before treatment to 6.1 (2.0) after treatment (P = 0.00). In multivariate analysis of patients who received treatment, higher pre-treatment fibrosis stages [odds ratio (OR) = 13.02, P < 0.00] were positively associated with improvement in fibrosis staging at 1-year follow-up. Higher BMI (OR = 0.93, P < 0.05) was negatively associated with improvement in fibrosis staging.
Discussion: This study supports the growing body of literature that suggests fibrosis regression is achievable in a significant number of patients who achieve SVR with all-oral DAA regimens. Equally important, fibrosis regression is more likely to occur in patients with advanced stages of fibrosis and less likely in patients who are obese.