Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents
Abstract Background Studies on temporal changes in noninvasive fibrosis indices and liver stiffness measurement (LSM) in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral agents (DAAs) are limited. Methods We retrospectively enrolled consecutive patients with CHC who had r...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-019-0973-5 |
| _version_ | 1831752277022474240 |
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| author | Wei-Fan Hsu Hsueh-Chou Lai Wen-Pang Su Chia-Hsin Lin Po-Heng Chuang Sheng-Hung Chen Hung-Yao Chen Hung-Wei Wang Guan-Tarn Huang Cheng-Yuan Peng |
| author_facet | Wei-Fan Hsu Hsueh-Chou Lai Wen-Pang Su Chia-Hsin Lin Po-Heng Chuang Sheng-Hung Chen Hung-Yao Chen Hung-Wei Wang Guan-Tarn Huang Cheng-Yuan Peng |
| author_sort | Wei-Fan Hsu |
| collection | DOAJ |
| description | Abstract Background Studies on temporal changes in noninvasive fibrosis indices and liver stiffness measurement (LSM) in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral agents (DAAs) are limited. Methods We retrospectively enrolled consecutive patients with CHC who had received DAAs. Results In total, we recruited 395 consecutive patients, of which 388 (98.2%) achieved a sustained virologic response (SVR) at 12 weeks after therapy. In patients who received DAA therapy and achieved SVR 12 weeks after therapy (n = 388), the median aspartate aminotransferase/platelet ratio index (APRI) value decreased from 1.19 (0.62–2.44) at baseline to 0.50 (0.32–0.95), 0.51 (0.31–0.92), 0.48 (0.31–0.88), and 0.52 (0.33–0.92) at week 2, week 4, end of therapy, and PW12, respectively (all P < 0.001). The median FIB-4 value decreased from 2.88 (1.56–5.60) at baseline to 2.10 (1.30–3.65), 2.15 (1.30–3.65), 2.11 (1.37–3.76), and 2.22 (1.45–3.82) at week 2, week 4, end of therapy, and PW12, respectively (all P < 0.001). The median alanine aminotransferase level significantly decreased from week 2 until PW12 (all P < 0.001). The platelet count significantly increased from 2 weeks after DAA therapy initiation until PW12 (all P < 0.001); however, the magnitude of changes in the platelet count was low. In patients with paired LSMs obtained using acoustic radiation force impulse elastography at baseline and PW12 (n = 199), the median LSM decreased from 1.78 (1.25–2.30) m/s at baseline to 1.38 (1.14–1.88) m/s at PW12 (P < 0.001). Conclusions Noninvasive fibrosis indices, namely APRI and FIB-4, exhibited a rapid and sustained decline from week 2 until PW12 in patients with CHC who achieved SVR to DAA therapy. The rapid decline in APRI and FIB-4 values might mainly result from improvement in necroinflammation. |
| first_indexed | 2024-12-21T23:00:37Z |
| format | Article |
| id | doaj.art-92d41d3b9efa4cdbb13e873213cefe0f |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-21T23:00:37Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-92d41d3b9efa4cdbb13e873213cefe0f2022-12-21T18:47:19ZengBMCBMC Gastroenterology1471-230X2019-04-011911910.1186/s12876-019-0973-5Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agentsWei-Fan Hsu0Hsueh-Chou Lai1Wen-Pang Su2Chia-Hsin Lin3Po-Heng Chuang4Sheng-Hung Chen5Hung-Yao Chen6Hung-Wei Wang7Guan-Tarn Huang8Cheng-Yuan Peng9Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalDivision of Hepatogastroenterology, Department of Internal Medicine, China Medical University HospitalAbstract Background Studies on temporal changes in noninvasive fibrosis indices and liver stiffness measurement (LSM) in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral agents (DAAs) are limited. Methods We retrospectively enrolled consecutive patients with CHC who had received DAAs. Results In total, we recruited 395 consecutive patients, of which 388 (98.2%) achieved a sustained virologic response (SVR) at 12 weeks after therapy. In patients who received DAA therapy and achieved SVR 12 weeks after therapy (n = 388), the median aspartate aminotransferase/platelet ratio index (APRI) value decreased from 1.19 (0.62–2.44) at baseline to 0.50 (0.32–0.95), 0.51 (0.31–0.92), 0.48 (0.31–0.88), and 0.52 (0.33–0.92) at week 2, week 4, end of therapy, and PW12, respectively (all P < 0.001). The median FIB-4 value decreased from 2.88 (1.56–5.60) at baseline to 2.10 (1.30–3.65), 2.15 (1.30–3.65), 2.11 (1.37–3.76), and 2.22 (1.45–3.82) at week 2, week 4, end of therapy, and PW12, respectively (all P < 0.001). The median alanine aminotransferase level significantly decreased from week 2 until PW12 (all P < 0.001). The platelet count significantly increased from 2 weeks after DAA therapy initiation until PW12 (all P < 0.001); however, the magnitude of changes in the platelet count was low. In patients with paired LSMs obtained using acoustic radiation force impulse elastography at baseline and PW12 (n = 199), the median LSM decreased from 1.78 (1.25–2.30) m/s at baseline to 1.38 (1.14–1.88) m/s at PW12 (P < 0.001). Conclusions Noninvasive fibrosis indices, namely APRI and FIB-4, exhibited a rapid and sustained decline from week 2 until PW12 in patients with CHC who achieved SVR to DAA therapy. The rapid decline in APRI and FIB-4 values might mainly result from improvement in necroinflammation.http://link.springer.com/article/10.1186/s12876-019-0973-5Aspartate aminotransferase/platelet ratio index (APRI)Chronic hepatitis CDirect-acting antiviral agentsFIB-4Liver stiffness measurementNoninvasive fibrosis index |
| spellingShingle | Wei-Fan Hsu Hsueh-Chou Lai Wen-Pang Su Chia-Hsin Lin Po-Heng Chuang Sheng-Hung Chen Hung-Yao Chen Hung-Wei Wang Guan-Tarn Huang Cheng-Yuan Peng Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents BMC Gastroenterology Aspartate aminotransferase/platelet ratio index (APRI) Chronic hepatitis C Direct-acting antiviral agents FIB-4 Liver stiffness measurement Noninvasive fibrosis index |
| title | Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents |
| title_full | Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents |
| title_fullStr | Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents |
| title_full_unstemmed | Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents |
| title_short | Rapid decline of noninvasive fibrosis index values in patients with hepatitis C receiving treatment with direct-acting antiviral agents |
| title_sort | rapid decline of noninvasive fibrosis index values in patients with hepatitis c receiving treatment with direct acting antiviral agents |
| topic | Aspartate aminotransferase/platelet ratio index (APRI) Chronic hepatitis C Direct-acting antiviral agents FIB-4 Liver stiffness measurement Noninvasive fibrosis index |
| url | http://link.springer.com/article/10.1186/s12876-019-0973-5 |
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