Study On The Changes Of Liver Fibrosis Levels Before And After Anti-Hepatitis C Virus Treatment By Direct Acting Antivirals

Objective:Hepatic fibrosis is a necessary process for the progression of chronic hepatitis to liver cirrhosis(LC).The primary objective of this study was to investigate whether the degree of liver fibrosis was improved in patients with hepatitis C virus(HCV)after successful treatment with direct acting antivirals(DAAs).Methods:A total of 111 patients with chronic hepatitis C who received SVR after treatment with DAAs were included in the study.Among them,77 patients in the chronic hepatitis group,13 patients in the compensated liver cirrhosis group,and 21 patients in the decompensated cirrhosis group,compared the changes in LSM,APRI,and Fib-4 before and after treatment with DAAs in each group.P<0.05 was considered statistically significant.Results:The WBC、PLT were increased,while ALT、AST、TBIL were decreased in CHC patients who achieved SVR after treatment with DAAs compared with before treatment,and the difference was statistically significant(t=2.946,P=0.004;t=2.308,P=0.023;t=-8.815,P<0.001;t=-9.044,P<0.001;t=2.540,P=0.013).The three liver fibrosis indexes LSM、APRI and Fib-4 were decreased in patients with SVR,and the differences were statistically significant(t=-7.800,P<0.001;t=-7.872,P<0.001;t=-5.826,P<0.001),in which the difference in liver fibrosis index was statistically significant in the compensated cirrhosis group and the decompensated cirrhosis group compared with the chronic hepatitis group(LSM:P~a=0.001,P~b=0.004;Fib-4:P~a=0.003,P~b<0.001;APRI:P~a<0.001,P~b<0.001),and there was no significant difference in compensated cirrhosis group and the decompensated cirrhosis group(LSM:P~c=0.052;Fib-4:P~c=0.294;APRI:P~c=0.193).Patients who achieved LSM improvement have had higher baseline of ALT、AST、APRI,and had lower baseline of WBC(P=0.045,OR=0.918;P=0.013,OR=0.862;P=0.032,OR=0.001;P=0.019,OR=2.508).Conclusion:Successful HCV eradication results in significant LSM improvement in CHC patients,and the best improvement occurs in LC patients.The baseline of WBC,ALT,AST,and APRI are independent predictors of the extent of LSM improvement in patients with CHC after SVR.The results of this study suggest that antiviral therapy should be initiated as soon as possible in patients with chronic hepatitis C.Early implementation of SVR can block further progression of liver inflammation and liver fibrosis in patients with chronic hepatitis C,thereby reducing the occurrence and development of cirrhosis decompensation complications.