Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El-Koom, Egypt.
Expert Rev Anti Infect Ther. 2021 Aug;19(8):1053-1059. doi: 10.1080/14787210.2021.1864326. Epub 2020 Dec 29.
Extent of post-treatment fibrosis change in patients with different stages of fibrosis not fully known. We aimed to study changes in liver fibrosis in chronic hepatitis C patients who were treated with pegylated interferon/ribavirin (PEG/RBV) or direct acting antivirals (DAAs).
Retrospective evaluation of results of transient elastography (TE) was done before and 1 year after end of treatment for patients treated with PEG/RBV ( = 268) and DAAs ( = 245).
The average age was 45.54 ± 10.64 years; mainly males. All patients in the DAAs group achieved sustained virological response (SVR), unlike 56.3% of the patients in the PEG/RBV group. F3-F4 fibrosis was predominant in the PEG/RBV nonresponder patients (51.3%) and DAAs responders (57.1%). TE decreased 1 year after end of treatment ( = 0.001) in the viral responders of the PEG/RBV group (7.44 ± 4.02 vs. 10.24 ± 7.29 kPa) and DAAs group (12.12 ± 9.21 vs. 16.81 ± 12.84 kPa) respectively. The delta TE change in the DAAs responders was higher than the PEG/RBV responders ( = 0.001) and PEG/RBV nonresponders ( = 0.001). The percentage of patients with liver fibrosis regression was higher in DAAs responders (52.5%) than in PEG/RBV responders (23.3%).
Treatment with DAAs is associated with fibrosis improvement more than treatment with PEG/RBV in chronic hepatitis C patients.
不同纤维化阶段患者治疗后纤维化程度的变化尚不完全清楚。我们旨在研究接受聚乙二醇干扰素/利巴韦林（PEG/RBV）或直接作用抗病毒药物（DAAs）治疗的慢性丙型肝炎患者肝纤维化的变化。
对接受 PEG/RBV（n=268）和 DAA（n=245）治疗的患者，治疗结束后 1 年进行瞬时弹性成像（TE）结果的回顾性评估。
平均年龄为 45.54±10.64 岁；主要为男性。DAAs 组所有患者均达到持续病毒学应答（SVR），而 PEG/RBV 组仅有 56.3%的患者达到 SVR。PEG/RBV 无应答者（51.3%）和 DAA 应答者（57.1%）中以 F3-F4 纤维化为主。PEG/RBV 组病毒应答者（7.44±4.02 比 10.24±7.29 kPa）和 DAA 组（12.12±9.21 比 16.81±12.84 kPa）治疗结束后 1 年 TE 均降低（均 P=0.001）。DAA 应答者的 TE 变化差值高于 PEG/RBV 应答者（P=0.001）和 PEG/RBV 无应答者（P=0.001）。DAA 应答者的肝纤维化缓解率（52.5%）高于 PEG/RBV 应答者（23.3%）。
与 PEG/RBV 相比，DAA 治疗慢性丙型肝炎患者的纤维化改善更为显著。
