Direkt etkili antiviral ajanlarla tedavi olan hepatit C hastalarında non-invaziv fibrozis indeks değerlerinin değişimi

Öz

Giriş ve Amaç: Her yıl yaklaşık 400 000 hepatit C virüs hastası siroza bağlı komplikasyonlardan ve hepatosellüler karsinomadan ölmektedir. Doğrudan etkili antiviraller, hepatit C virüs enfeksiyonu olan hastaların %90’ından fazlasında sürekli bir virolojik yanıt sağlar. Bu çalışmada doğrudan etkili antivirallerle tedavi edilen hepatit C virüslü hastalarda non-invaziv fibrozis indeksindeki değişikliği değerlendirmeyi amaçladık. Gereç ve Yöntem: Doğrudan etkili antiviral teadavisi alan hepatit C virüslü hastalar analiz edildi. Her hasta için FIB-4 ve APRI hesaplandı. Bulgular: Toplam 88 hastanın 46'sı (%52) erkek, 21'i (%23.8) sirotikti. Ortalama yaş 58 yıl idi. Başlangıçtan tedavi bitimine kadar non-invaziv skorlarda anlamlı düşüş gösterildi (p < 0.001). Başlangıçtan sürekli bir virolojik yanıt sonrasına kadar ortalama FIB-4 ve APRI skorlarında istatistiksel olarak anlamlı bir düşüş vardı (p < 0.001). Uzun süreli takipte, sürekli bir virolojik yanıt sonrası 15 ayda düşük FIB-4 ve APRI'nin devam ettiği gözlendi. Çalışmamızda ortalama takip süresi 27.8 ± 24.3 ay olup, takipte doğrudan etkili antiviral tedavisi sonrası sadece bir hastaya hepatosellüler kanser tanısı konuldu. Sonuç: FIB-4 ve APRI skorlarındaki erken düşüş, karaciğer enzimlerindeki azalma ile ilişkili olabilir. Bununla birlikte, takiplerde düşük düzeyde invaziv olmayan skorların devam etmesi, nekroinflamasyonda bir azalma ile ilişkilendirilmiştir.

Anahtar Kelimeler

• Direkt etkili anti-viral ajanlar
• hepatit C virüsü
• non-invasiv fibrozis skorları

The changing non-invasive fibrosis index value in patients with hepatitis C treated with direct-acting antiviral agents

Öz

Background and Aims: About 400 000 patients with hepatitis C virus die from cirrhosis-related complications and hepatocellular carcinoma every year. Direct-acting antivirals provide a sustained virologic response in more than 90% of patients with hepatitis C virus infection. We aimed to evaluate the alteration of the non-invasive fibrosis index in patients with hepatitis C virus who were treated with direct-acting antivirals. Materials and Method: Patients with hepatitis C virus who received a complete course of direct-acting antivirals were analyzed. FIB-4 and APRI were calculated for each patient. Results: Of the 88 patients, 46 (52%) were males, and 21 (23.8%) were cirrhotics. The mean age was 58 years. The significant decrease was showed in the non-invasive scores compared from the baseline to the end of treatment. There was a statistically significant drop in mean FIB-4 and APRI scores from baseline to post sustained virologic response (p < 0.001). In the long-term follow-up, it was observed to continue low FIB-4 and APRI at 15 months post sustained virologic response. Mean follow up-time was 27.8 ± 24.3 months in our study, and just one patient was diagnosed with hepatocellular cancer after direct-acting antivirals treatment during follow-up. Conclusion: An early decline in FIB-4 and APRI scores can be related to a decrease in liver enzymes. Nonetheless, maintaining a low level of non-invasive markers has been linked to a reduction in necroinflammation.

Anahtar Kelimeler

• Direct-acting anti-viral agents
• hepatitis C virus
• non-invasive fibrosis index

Kaynakça

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