Long-Term Impact of Hepatitis C Virus Eradication on Liver Stiffness in Egyptian Patients

Area of Science:

• Hepatology
• Virology
• Fibrosis research

Background:

• Hepatitis C virus (HCV) infection can lead to liver fibrosis and cirrhosis.
• Direct-acting antivirals (DAAs) have revolutionized HCV treatment, leading to sustained virologic response.
• The long-term impact of HCV clearance on liver stiffness and fibrosis progression requires further investigation.

Purpose of the Study:

• To assess the serial changes in liver stiffness measurements (LSM) after HCV clearance in patients treated with DAAs.
• To evaluate the regression of liver fibrosis stages over a 5-year follow-up period.
• To determine the rate of cirrhosis reversal following successful HCV treatment.

Main Methods:

• A cohort of 655 patients treated with DAAs for HCV were followed for 1, 3, and 5 years.
• Liver stiffness measurements (LSM) were serially assessed using transient elastography.
• Fibrosis staging was categorized using the F0-F4 scale.

Main Results:

• Significant decreases in LSM were observed in both non-cirrhotic and cirrhotic patients (p < 0.0001).
• In non-cirrhotics, LSM decreased from 8.29±2.3 kPa to 4.03±1.0 kPa.
• In cirrhotics, LSM decreased from 29.66±14.25 kPa to 22.50±11.16 kPa.
• The proportion of patients with advanced fibrosis (F3-F4) decreased significantly, with 27.7% showing cirrhosis reversal.

Conclusions:

• Sustained HCV eradication leads to significant regression of liver stiffness across all fibrosis stages.
• While mild fibrosis (F0-F2) improves rapidly, advanced fibrosis (F3-F4) regression is a slower process.
• DAA treatment offers a substantial potential for reversing liver cirrhosis in a significant proportion of patients.