Fibrosis Regression Post Direct-acting Antiviral Treatment in Hepatitis C Virus Patients

Objective: We studied long-term serial changes in aspartate aminotransferase/platelet ratio index (APRI) and fibrosis-4 (FIB-4) scores in hepatitis C virus patients with a sustained virologic response after direct-acting antiviral (DAA) therapy.Methods: Seventy-five patients treated with DAA were included in this study. APRI and FIB-4 scores were calculated at the beginning of DAA treatment, at the end of treatment (EOT), one and two years after treatment.Results: Twenty-eight patients had cirrhosis. APRI and FIB-4 scores (1.38 vs. 0.49, p<0.001; 4.25 vs. 2.79, p<0.001) Improved in all patients at the EOT. There was also a trend toward decreased scores for APRI and FIB-4 at follow-up based on EOT of 2nd-year results (APRI, 0.49 vs. 0.41, p=0.87; FIB-4, 2.79 vs. 2.50, p=0.44). There were significant improvements in cirrhotic patients' two-year APRI and FIB-4 scores (0.86 vs. 0.58, p<0.001; 4.74 vs. 3.59, p<0.001). Similarly, in the 1st and second years, APRI and FIB-4 scores were compared after EOT in cirrhotic patients (0.84 vs. 0.58, p=0.007; 4.74 vs. 3.59, p=0.004) and showed remarkable improvement.Conclusion: Improvements in liver fibrosis markers were prominent in patients with advanced fibrosis. The regression in liver fibrosis based on non-invasive tests has persisted even two years after the treatment.