Department of Pediatrics, Cairo University, Cairo, Egypt.
Department of Pediatrics, Cairo University, Cairo, Egypt.
J Pediatr. 2021 Jun;233:126-131. doi: 10.1016/j.jpeds.2021.02.012. Epub 2021 Feb 9.
To assess the degree of liver stiffness using transient elastography in Egyptian children infected with hepatitis C virus (HCV) at baseline and 1 year after achievement of sustained virologic response (SVR) with direct acting antivirals.
This prospective study included children infected with HCV who received treatment with sofosbuvir/ledipasvir and achieved SVR. At baseline and 1 year after achievement of SVR, the extent of hepatic fibrosis was assessed by transient elastography using FibroScan to measure liver stiffness, in addition to noninvasive markers including aspartate aminotransferase/platelet ratio index (APRI) and fibrosis-4 (FIB-4) index.
The study included 23 cases that had variable degrees of fibrosis at baseline; their ages ranged between 10 and 18 years. At baseline, 13 patients had F1; 3 patients had F1-F2; 1 patient had F2; 3 patients had F3; 2 had F3-F4; and 2 patients with F4. One year after achievement of SVR, there was a statistically significant improvement in liver stiffness, APRI, and FIB-4 index (P = .03, <.001, .02, respectively). In 13 patients (56.5%), the liver stiffness improved; in 7 patients, it was stationary; and the remaining 3 patients showed mild increase in liver stiffness that was, however, associated with improvement in APRI and FIB-4 index. Comorbid conditions and previous treatment with interferon were not associated with increased liver stiffness 1 year after SVR.
Egyptian children infected with HCV genotype 4 achieved significant regression in liver stiffness after treatment with direct acting antivirals.
使用瞬时弹性成像技术评估埃及丙型肝炎病毒 (HCV) 感染儿童在获得直接作用抗病毒药物持续病毒学应答 (SVR) 时的基线和 1 年后的肝脏硬度程度。
本前瞻性研究纳入了接受索非布韦/雷迪帕韦治疗并获得 SVR 的 HCV 感染儿童。在基线和获得 SVR 后 1 年，使用 FibroScan 通过瞬时弹性成像技术评估肝纤维化程度，以测量肝脏硬度，同时还包括非侵入性标志物，如天门冬氨酸氨基转移酶/血小板比值指数 (APRI) 和纤维化-4 (FIB-4) 指数。
本研究纳入了 23 例基线时存在不同程度纤维化的病例；他们的年龄在 10 至 18 岁之间。基线时，13 例患者为 F1 期；3 例患者为 F1-F2 期；1 例患者为 F2 期；3 例患者为 F3 期；2 例患者为 F3-F4 期；2 例患者为 F4 期。获得 SVR 后 1 年，肝脏硬度、APRI 和 FIB-4 指数均有统计学显著改善（P=0.03、<0.001、0.02，分别）。13 例（56.5%）患者肝脏硬度改善；7 例患者肝脏硬度稳定；其余 3 例患者肝脏硬度轻度增加，但 APRI 和 FIB-4 指数有所改善。合并症和干扰素治疗史与 SVR 后 1 年肝脏硬度增加无关。
埃及 HCV 基因型 4 感染儿童在接受直接作用抗病毒药物治疗后，肝脏硬度显著降低。
