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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 2
Mar.  2021
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Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(2): 314-317

Virological response to direct-acting antiviral therapy and changes in liver fibrosis indices in chronic hepatitis C patients with different alanine aminotransferase and aspartate aminotransferase levels in a real-world setting

DOI: 10.3969/j.issn.1001-5256.2021.02.014

  • Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China

  • Received Date: 2020-08-28
  • Accepted Date: 2020-10-22
  • Published Date: 2021-02-20
    Abstract
  •   Objective  To investigate the virologic response to direct-acting antiviral (DAA) therapy and the changes in liver stiffness measurement (LSM), fibrosis-4 (FIB-4), and aspartate aminotransferase-to-platelet ratio index (APRI) after treatment in chronic hepatitis C (CHC) patients with different alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at baseline in a real-world setting.  Methods  CHC patients who attended the outpatient service of Department of Infectious Diseases, Peking University First Hospital, from December 2017 to May 2020 were enrolled, and virologic response rate was calculated. The Wilcoxon rank-sum test was used to compare LSM, FIB-4, and APRI between groups at baseline and at 12 weeks after treatment, and the chi-square test was used for comparison of categorical data between groups.  Results  A total of 48 CHC patients were enrolled, among whom 33.3% had abnormal ALT or AST at baseline. Among these patients, the virologic response rate was 85.4% at week 4 of treatment and 100% at the end of treatment and at 12, 24, and 48 weeks after treatment, and there were significant changes from baseline to 12 weeks after treatment in LSM [6.1 (5.1-12.4) kPa vs 8.6 (5.7-16.9) kPa, Z=-1.676, P=0.043] and APRI [0.24(0.19-0.48) vs 0.42(0.23-1.17), Z=-2.050, P=0.027]. From baseline to 12 weeks after treatment, the patients with abnormal ALT or AST at baseline had significant changes in LSM [8.9(5.6-13.1) kPa vs 14.4(8.0-28.2) kPa, Z=-1.679, P=0.047] and APRI [0.44(0.25-0.50) vs 1.29(0.99-2.09), Z=-3.427, P=0.001].  Conclusion  CHC patients achieve a high sustained virologic response rate after DAA therapy, and the patients with abnormal ALT or AST at baseline tend to have more significant improvements in LSM and APRI than those without such abnormality.

     

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    • References(11)
  • [1]
    Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for hepatitis C (2019 version)[J]. J Clin Hepatol, 2019, 35(12): 2670-2686. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.12.008

    中华医学会肝病学分会, 中华医学会感染病分会. 丙型肝炎防治指南(2019)年版[J]. 临床肝胆病杂志, 2019, 35(12): 2670-2686. DOI: 10.3969/j.issn.1001-5256.2019.12.008
    [2]
    van der MEER AJ, BERENGUER M. Reversion of disease manifestations after HCV eradication[J]. J Hepatol, 2016, 65(1 Suppl): s95-s108.
    [3]
    Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for hepatitis C: A 2015 update[J]. J Clin Hepatol, 2015, 31(12): 1961-1979. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2015.12.003

    中华医学会肝病学分会, 中华医学会感染病分会. 丙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31(12): 1961-1979. DOI: 10.3969/j.issn.1001-5256.2015.12.003
    [4]
    Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association. Consensus on the diagnosis and therapy of hepatic fibrosis(2019)[J]. J Clin Hepatol, 2019, 35(10): 2163-2172. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.10.007

    中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会. 肝纤维化诊断及治疗共识(2019年)[J]. 临床肝胆病杂志, 2019, 35(10): 2163-2172. DOI: 10.3969/j.issn.1001-5256.2019.10.007
    [5]
    SHAHID M, IDREES M, NASIR B, et al. Correlation of biochemical markers and HCV RNA titers with fibrosis stages and grades in chronic HCV-3a patients[J]. Eur J Gastroenterol Hepatol, 2014, 26(7): 788-794. DOI: 10.1097/MEG.0000000000000109
    [6]
    BACHOFNER JA, VALLI PV, KROGER 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[J]. Liver Int, 2017, 37(3): 369-376. DOI: 10.1111/liv.13256
    [7]
    SNYDER N, GAJULA L, XIAO SY, et al. APRI: An easy and validated predictor of hepatic fibrosis in chronic hepatitis C[J]. J Clin Gastroenterol, 2006, 40(6): 535-542. DOI: 10.1097/00004836-200607000-00013
    [8]
    LIANG J, ZHANG YP, LIU F, et al. Efficacy of direct-acting antiviral agents in treatment of chronic hepatitis C and its effect on liver stiffness and aspartate aminotransferase-to-platelet ratio index[J]. J Clin Hepatol, 2020, 36(6): 1263-1267. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2020.06.015

    梁静, 张亚苹, 刘芳, 等. 直接抗病毒药物治疗慢性丙型肝炎的效果及对肝硬度、APRI的影响[J]. 临床肝胆病杂志, 2020, 36(6): 1263-1267. DOI: 10.3969/j.issn.1001-5256.2020.06.015
    [9]
    PARCZEWSKI M, KORDEK J, JANCZEWSKA E, et al. Hepatitis C virus (HCV) genotype 1 NS5A resistance-associated variants are associated with advanced liver fibrosis independently of HCV-transmission clusters[J]. Clin Microbiol Infect, 2019, 25(4): 513.
    [10]
    MAYLIN S, LAOUENAN C, MARTINOT-PEIGNOUX M, et al. Role of hepatic HCV-RNA level on the severity of chronic hepatitis C and response to antiviral therapy[J]. J Clin Virol, 2012, 53(1): 43-47. DOI: 10.1016/j.jcv.2011.09.029
    [11]
    IOANNOU GN, FELD JJ. What are the benefits of a sustained virologic response to direct-acting antiviral therapy for hepatitis C virus infection?[J]. Gastroenterology, 2019, 156(2): 446-460. DOI: 10.1053/j.gastro.2018.10.033
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