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Analysis of hepatic stiffness after viral eradication in a population with chronic hepatitis C treated with DAAs

Moris Sangineto1, Chiara Valentina Luglio2, Tommaso Mastrofilippo1

  • 1Department of Interdisciplinary Medicine, University of Bari, Bari, Italy.

Medicina Clinica
|August 14, 2020
PubMed

Insights

Direct-acting antivirals (DAAs) improve liver stiffness in chronic hepatitis C (CHC) patients. However, high baseline glucose levels impede fibrosis regression and may increase hepatocellular carcinoma (HCC) risk, highlighting the importance of glycemic control.

Area of Science:

  • Hepatology
  • Viral Hepatitis
  • Metabolic Syndrome

Background:

  • Chronic hepatitis C (CHC) remains a significant global health issue.
  • Direct-acting antivirals (DAAs) achieve high sustained virologic response (SVR) rates.
  • Factors influencing fibrosis regression and hepatocellular carcinoma (HCC) development post-SVR require further investigation.

Purpose of the Study:

  • To evaluate hepatic stiffness regression at 24 weeks post-SVR (SVR24).
  • To identify factors impacting hepatic stiffness changes after DAA treatment.
  • To explore the relationship between glycemic status and outcomes in CHC patients post-DAA therapy.

Main Methods:

  • Retrospective analysis of 166 CHC patients treated with DAAs.
  • Assessment of hepatic stiffness using acoustic radiation force impulse (ARFI).
  • Collection of anthropometric and biochemical parameters at baseline and SVR24.

Main Results:

  • Viral eradication significantly improved hepatic stiffness, liver enzymes (ALT, AST, γGT), and platelet count.
  • Patients with baseline glucose > 110 mg/dL showed significantly less hepatic stiffness regression.
  • Baseline HbA1c strongly correlated with the change in hepatic stiffness (DeltaStiffness).
  • Hyperglycemic patients who developed HCC (4.2%) exhibited no stiffness regression or platelet count recovery.

Conclusions:

  • DAA treatment offers overall benefits for CHC patients, including improved liver stiffness.
  • Glycemic decompensation negatively impacts liver fibrosis regression.
  • Hyperglycemia may facilitate HCC development in CHC patients post-DAA therapy.
Abstract

Keywords:
Antiviral de acción directaCarcinoma hepatocelularDirect-acting antiviralFibrosisGlucosaGlucoseHepatitisHepatocellular carcinomaMetabolismMetabolismo

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