Liver-fibrosis regression seen after hepatitis C cure

Last Updated: 2018-08-28

By Reuters Staff

NEW YORK (Reuters Health) - Liver fibrosis regresses in some patients with chronic hepatitis C infection who achieve a sustained virological response (SVR) to oral direct-acting antivirals (DAA), according to a retrospective study.

Inhibition of hepatitis C virus (HCV) replication with DAA appears to reduce liver inflammation, but there is little information regarding the impact of treatment and cure of HCV infection on liver fibrosis.

Dr. Carmen de Mendoza from Research Institute Puerta de Hierro-Segovia de Arana, in Madrid, Spain, and colleagues investigated changes in liver fibrosis, as measured by hepatic elastography (Fibroscan), in 246 HCV-infected patients who achieved an SVR.

More than half of the patients (57.2%) had advanced liver fibrosis at baseline, 18.4% had decompensated cirrhosis and 42% were co-infected with HIV.

Median Fibroscan values declined from 11 kPa at baseline to 8.2 kPa at the time of SVR12, regardless of HIV status, and declined to a greater extent in the subset of patients with advanced fibrosis (from 19 kPa to 14.1 kPa), the researchers reported in AIDS, online August 8.

Significant reductions in fibrosis occurred more often in patients with advanced fibrosis than in those with null-mild fibrosis (52.3% vs. 22.5%), but 41.4% of individuals with advanced liver fibrosis did not show meaningful improvements.

In multivariable analysis, high baseline Fibroscan values were the only independent predictors of more pronounced fibrosis regression.

"Despite improvements being more pronounced in the subset of patients with baseline advanced fibrosis or cirrhosis," the researchers conclude, "a large group of them persist with cirrhosis after being cured and warrant further clinical follow-up, including periodic screening for liver cancer."

Dr. de Mendoza did not respond to a request for comments.

SOURCE: https://bit.ly/2MQ0VDK

AIDS 2018.