Can anti-viral therapy reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus

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Viral Eradication Reduces Both Liver Stiffness and Steatosis in Patients With Chronic Hepatitis C Virus Infection Who Received Direct-acting Anti-viral Therapy
In this study, we investigated changes in liver stiffness and steatosis as determined by MRI in patients with chronic HCV genotype 1 or 2 infection who received direct-acting anti-viral therapy and achieved SVR.

May 29, 2018 

Viral Eradication Reduces Both Liver Stiffness and Steatosis in Patients With Chronic Hepatitis C Virus Infection Who Received Direct-acting Anti-viral Therapy

T. Tada; T. Kumada; H. Toyoda; Y. Sone; K. Takeshima; S. Ogawa; T. Goto; A. Wakahata; M. Nakashima; M. Nakamuta; J. Tanaka

Abstract
Background Whether direct-acting anti-viral therapy can reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus (HCV) infection is unclear.

Aims To evaluate changes in liver stiffness and steatosis in patients with HCV who received direct-acting anti-viral therapy and achieved sustained virological response (SVR).

Methods A total of 198 patients infected with HCV genotype 1 or 2 who achieved SVR after direct-acting anti-viral therapy were analysed. Liver stiffness as evaluated by magnetic resonance elastography, steatosis as evaluated by magnetic resonance imaging-determined proton density fat fraction (PDFF), insulin resistance, and laboratory data were assessed before treatment (baseline) and at 24 weeks after the end of treatment (SVR24).

Results Alanine aminotransferase and homeostatic model assessment-insulin resistance levels decreased significantly from baseline to SVR24. Conversely, platelet count, which is inversely associated with liver fibrosis, increased significantly from baseline to SVR24. In patients with high triglyceride levels (≥150 mg/dL), triglyceride levels significantly decreased from baseline to SVR24 (P = 0.004). The median (interquartile range) liver stiffness values at baseline and SVR24 were 3.10 (2.70–4.18) kPa and 2.80 (2.40–3.77) kPa respectively (P < 0.001). The PDFF values at baseline and SVR 24 were 2.4 (1.7–3.4)% and 1.9 (1.3–2.8)% respectively (P < 0.001). In addition, 68% (19/28) of patients with fatty liver at baseline (PDFF ≥5.2%; n = 28) no longer had fatty liver (PDFF <5.2%) at SVR24.

Conclusion Viral eradication reduces both liver stiffness and steatosis in patients with chronic HCV who received direct-acting anti-viral therapy (UMIN000017020).

Full-Text Article: http://www.medscape.com/viewarticle/893744