Research Article
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The effect of direct-acting antivirals (DAA) on confirmed noninvasive fibrous parameters in chronic hepatitis C patients

Year 2023, , 426 - 431, 27.10.2023
https://doi.org/10.38053/acmj.1343277

Abstract

Aims: Chronic hepatitis C (CHC) is an important public health problem in terms of the number of people it affects worldwide and the diseases it causes. The high sustained virological response (SVR) rates achieved by the use of direct-acting antiviral (DAA) drugs in the recent period have shown that a new era has begun in this disease. It was aimed to evaluate the effect of DAAs on confirmed noninvasive fibrous parameters together with their effectiveness.
Methods: 75 patients who were started on DAA treatment for CHC were included in the study. In addition, laboratory parameters values at the beginning of the treatment, 12 and 24 weeks after the end of the treatment, hepatitis C virus ribonucleic acid (HCV RNA) results and Aminotransferase-to-Platelet Ratio Index (APRI), Fibrosis-4 (FIB-4) scores were compared.
Results: The most common comorbidity in patients is hypertension (HT), and the most common source of transmission is surgical operations. Genotype 1b was the dominant genotype. The SVR rates of all patients 12 and 24 weeks after the end of treatment were 100%. The APRI and FIB-4 scores of the patients decreased significantly at the 12th and 24th weeks at the end of the treatment compared to the beginning of the treatment.
Conclusion: The confirmed noninvasive fibrous parameters used in the treatment of CHC are useful in evaluating the results of the treatments applied.

References

  • Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61(1):45-57.
  • Singal AG, Volk ML, Jensen D, Bisceglie AMD, Schoenfeld PS. A sustained viral response is associated with reduced liver-related morbidity and mortality in patients with hepatitis C virus. Clin Gastroenterol Hepatol. 2010;8(3):280-288. e1.
  • Ryder S. Progression of hepatic fibrosis in patients with hepatitis C: a prospective repeat liver biopsy study. Gut. 2004;53(3):451-455.
  • Ozturk-Cerik H, Esen S, Altintas-Oner B, Celik M, Ozdemir T, Tanyel E. Evaluation of the effectiveness of direct-acting antiviral agents in patients with hepatitis C/hepatit C hastalarinda dogrudan etkili antiviral ilaclarin etkinliginin degerlendirilmesi. KLIMIK J. 2020;33(3):297-307.
  • Tachi Y, Hirai T, Toyoda H, et al. Predictive ability of laboratory indices for liver fibrosis in patients with chronic hepatitis C after the eradication of hepatitis C virus. PLoS One. 2015;10(7):e0133515.
  • Wai C-T, Greenson JK, Fontana RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003;38(2):518-526.
  • Chan J, Gogela N, Zheng H, et al. Direct-acting antiviral therapy for chronic HCV infection results in liver stiffness regression over 12 months post-treatment. Digest Dis Sci. 2018;63(2):486-492.
  • Li W, Liang J, An J, et al. Geographic distribution of HCV genotypes and efficacy of direct-acting antivirals in chronic HCV-infected patients in North and Northeast China: a real-world multicenter study. Canad J Gastroenterol Hepatol. 2022;2022:7395506.
  • Sulkowski MS, Gardiner DF, Rodriguez-Torres M, et al. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014;370(3):211-21.
  • Bulut ME, Topalca US, Murat A, et al. HCV genotype distribution of patients with chronic hepatitis C in İstanbul. Sisli Etfal Hastan Tip Bul. 2021;55(1):86.
  • Çetin Duran A, Kibar F, Çetiner S, Yaman A. Determination of hepatitis C virus genotype and HCV infection transmission routes in Cukurova University Medical Faculty Hospital. Turk Hij Den Biol Derg. 2017;74(3):201-210.
  • Alter MJ. Epidemiology of hepatitis C virus infection. WJG. 2007;13(17):2436.
  • Karaca Ç, Çakaloğlu Y, Demir K, et al. Risk factors for the transmission of hepatitis C virus infection in the Turkish population. Dig Dis Sci. 2006;51(2):365-369.
  • Azmi AN, Tan S-S, Mohamed R. Hepatitis C and kidney disease: an overview and approach to management. World J Hepatol. 2015;7(1):78.
  • Schmid M, Kreil A, Jessner W, et al. Suppression of haematopoiesis during therapy of chronic hepatitis C with different interferon α mono and combination therapy regimens. Gut. 2005;54(7):1014-1020.
  • Holmberg SD, Lu M, Rupp LB, et al. Noninvasive serum fibrosis markers for screening and staging chronic hepatitis C virus patients in a large US cohort. Clin Infect Dis. 2013;57(2):240-246.
  • Li J, Gordon S, Rupp L, et al. The validity of serum markers for fibrosis staging in chronic hepatitis B and C. J Viral Hepat. 2014;21(12):930-937.
  • Pan JJ, Bao F, Du E, et al. Morphometry confirms fibrosis regression from sustained virologic response to direct‐acting antivirals for hepatitis C. Hepatol Communicat. 2018;2(11):1320-1330.
  • Bachofner JA, Valli PV, Kröger A, et al. Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis‐4 score and aspartate aminotransferase‐platelet ratio index. Liver Int. 2017;37(3):369-376.
  • Huang R, Rao H, Yang M, et al. Noninvasive measurements predict liver fibrosis well in hepatitis C virus patients after direct-acting antiviral therapy. Dig Dis Sci. 2020;65(5):1491-1500.
  • Hsu W-F, Lai H-C, Su W-P, et al. Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents. BMC Gastroenterol. 2019;19(1):1-9.
  • Karasu Z, Tekin F, Ersoz G, et al. Liver fibrosis is associated with decreased peripheral platelet count in patients with chronic hepatitis B and C. Digest Dis Sci. 2007;52(6):1535-1539.
  • Lalor PF, Herbert J, Bicknell R, Adams DH. Hepatic sinusoidal endothelium avidly binds platelets in an integrin-dependent manner, leading to platelet and endothelial activation and leukocyte recruitment. Am J Physiol Gastrointest Liver Physiol. 2013;304(5):469-478.
  • Chauhan A, Adams DH, Watson SP, Lalor PF. Platelets: No longer bystanders in liver disease. Hepatology. 2016;64(5):1774-1784.
  • Streiff MB, Mehta S, Thomas DL. Peripheral blood count abnormalities among patients with hepatitis C in the United States. Hepatology. 2002;35(4):947-952.
  • Deterding K, Höner Zu Siederdissen C, Port K, et al. Improvement of liver function parameters in advanced HCV‐associated liver cirrhosis by IFN‐free antiviral therapies. Aliment Pharmacol Ther. 2015;42(7):889-901.
  • Pons M, Santos B, Simón-Talero M, et al. Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals. Therap Adv Gastroenterol. 2017;10(8):619-629.
  • Giannini E, Botta F, Borro P, et al. Relationship between thrombopoietin serum levels and liver function in patients with chronic liver disease related to hepatitis C virus infection. Am J Gastroenterol. 2003;98(11):2516-2520.
  • Iwasaki Y, Takaguchi K, Ikeda H, et al. Risk factors for hepatocellular carcinoma in hepatitis C patients with sustained virologic response to interferon therapy. Liver Int. 2004;24(6):603-610.
  • Makiyama A, Itoh Y, Kasahara A, et al. Characteristics of patients with chronic hepatitis C who develop hepatocellular carcinoma after a sustained response to interferon therapy. Cancer. 2004;101(7):1616-1622.
Year 2023, , 426 - 431, 27.10.2023
https://doi.org/10.38053/acmj.1343277

Abstract

References

  • Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61(1):45-57.
  • Singal AG, Volk ML, Jensen D, Bisceglie AMD, Schoenfeld PS. A sustained viral response is associated with reduced liver-related morbidity and mortality in patients with hepatitis C virus. Clin Gastroenterol Hepatol. 2010;8(3):280-288. e1.
  • Ryder S. Progression of hepatic fibrosis in patients with hepatitis C: a prospective repeat liver biopsy study. Gut. 2004;53(3):451-455.
  • Ozturk-Cerik H, Esen S, Altintas-Oner B, Celik M, Ozdemir T, Tanyel E. Evaluation of the effectiveness of direct-acting antiviral agents in patients with hepatitis C/hepatit C hastalarinda dogrudan etkili antiviral ilaclarin etkinliginin degerlendirilmesi. KLIMIK J. 2020;33(3):297-307.
  • Tachi Y, Hirai T, Toyoda H, et al. Predictive ability of laboratory indices for liver fibrosis in patients with chronic hepatitis C after the eradication of hepatitis C virus. PLoS One. 2015;10(7):e0133515.
  • Wai C-T, Greenson JK, Fontana RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003;38(2):518-526.
  • Chan J, Gogela N, Zheng H, et al. Direct-acting antiviral therapy for chronic HCV infection results in liver stiffness regression over 12 months post-treatment. Digest Dis Sci. 2018;63(2):486-492.
  • Li W, Liang J, An J, et al. Geographic distribution of HCV genotypes and efficacy of direct-acting antivirals in chronic HCV-infected patients in North and Northeast China: a real-world multicenter study. Canad J Gastroenterol Hepatol. 2022;2022:7395506.
  • Sulkowski MS, Gardiner DF, Rodriguez-Torres M, et al. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014;370(3):211-21.
  • Bulut ME, Topalca US, Murat A, et al. HCV genotype distribution of patients with chronic hepatitis C in İstanbul. Sisli Etfal Hastan Tip Bul. 2021;55(1):86.
  • Çetin Duran A, Kibar F, Çetiner S, Yaman A. Determination of hepatitis C virus genotype and HCV infection transmission routes in Cukurova University Medical Faculty Hospital. Turk Hij Den Biol Derg. 2017;74(3):201-210.
  • Alter MJ. Epidemiology of hepatitis C virus infection. WJG. 2007;13(17):2436.
  • Karaca Ç, Çakaloğlu Y, Demir K, et al. Risk factors for the transmission of hepatitis C virus infection in the Turkish population. Dig Dis Sci. 2006;51(2):365-369.
  • Azmi AN, Tan S-S, Mohamed R. Hepatitis C and kidney disease: an overview and approach to management. World J Hepatol. 2015;7(1):78.
  • Schmid M, Kreil A, Jessner W, et al. Suppression of haematopoiesis during therapy of chronic hepatitis C with different interferon α mono and combination therapy regimens. Gut. 2005;54(7):1014-1020.
  • Holmberg SD, Lu M, Rupp LB, et al. Noninvasive serum fibrosis markers for screening and staging chronic hepatitis C virus patients in a large US cohort. Clin Infect Dis. 2013;57(2):240-246.
  • Li J, Gordon S, Rupp L, et al. The validity of serum markers for fibrosis staging in chronic hepatitis B and C. J Viral Hepat. 2014;21(12):930-937.
  • Pan JJ, Bao F, Du E, et al. Morphometry confirms fibrosis regression from sustained virologic response to direct‐acting antivirals for hepatitis C. Hepatol Communicat. 2018;2(11):1320-1330.
  • Bachofner JA, Valli PV, Kröger A, et al. Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis‐4 score and aspartate aminotransferase‐platelet ratio index. Liver Int. 2017;37(3):369-376.
  • Huang R, Rao H, Yang M, et al. Noninvasive measurements predict liver fibrosis well in hepatitis C virus patients after direct-acting antiviral therapy. Dig Dis Sci. 2020;65(5):1491-1500.
  • Hsu W-F, Lai H-C, Su W-P, et al. Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents. BMC Gastroenterol. 2019;19(1):1-9.
  • Karasu Z, Tekin F, Ersoz G, et al. Liver fibrosis is associated with decreased peripheral platelet count in patients with chronic hepatitis B and C. Digest Dis Sci. 2007;52(6):1535-1539.
  • Lalor PF, Herbert J, Bicknell R, Adams DH. Hepatic sinusoidal endothelium avidly binds platelets in an integrin-dependent manner, leading to platelet and endothelial activation and leukocyte recruitment. Am J Physiol Gastrointest Liver Physiol. 2013;304(5):469-478.
  • Chauhan A, Adams DH, Watson SP, Lalor PF. Platelets: No longer bystanders in liver disease. Hepatology. 2016;64(5):1774-1784.
  • Streiff MB, Mehta S, Thomas DL. Peripheral blood count abnormalities among patients with hepatitis C in the United States. Hepatology. 2002;35(4):947-952.
  • Deterding K, Höner Zu Siederdissen C, Port K, et al. Improvement of liver function parameters in advanced HCV‐associated liver cirrhosis by IFN‐free antiviral therapies. Aliment Pharmacol Ther. 2015;42(7):889-901.
  • Pons M, Santos B, Simón-Talero M, et al. Rapid liver and spleen stiffness improvement in compensated advanced chronic liver disease patients treated with oral antivirals. Therap Adv Gastroenterol. 2017;10(8):619-629.
  • Giannini E, Botta F, Borro P, et al. Relationship between thrombopoietin serum levels and liver function in patients with chronic liver disease related to hepatitis C virus infection. Am J Gastroenterol. 2003;98(11):2516-2520.
  • Iwasaki Y, Takaguchi K, Ikeda H, et al. Risk factors for hepatocellular carcinoma in hepatitis C patients with sustained virologic response to interferon therapy. Liver Int. 2004;24(6):603-610.
  • Makiyama A, Itoh Y, Kasahara A, et al. Characteristics of patients with chronic hepatitis C who develop hepatocellular carcinoma after a sustained response to interferon therapy. Cancer. 2004;101(7):1616-1622.
There are 30 citations in total.

Details

Primary Language English
Subjects Medical Infection Agents
Journal Section Research Articles
Authors

Dilek Bulut 0000-0001-5874-174X

Merve Sefa Sayar 0000-0002-0436-4122

Ali Acar 0000-0003-2008-5112

Early Pub Date October 26, 2023
Publication Date October 27, 2023
Published in Issue Year 2023

Cite

AMA Bulut D, Sayar MS, Acar A. The effect of direct-acting antivirals (DAA) on confirmed noninvasive fibrous parameters in chronic hepatitis C patients. Anatolian Curr Med J / ACMJ / acmj. October 2023;5(4):426-431. doi:10.38053/acmj.1343277

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