Department of Clinical Medicine, Botucatu Medical School, São Paulo State University (UNESP), Av. Prof. Mário Rubens Guimarães Montenegro, s/n - UNESP, Botucatu, São Paulo, Brazil.
Undergraduate Course in Medicine, Taubaté Medical School - UNITAU, Taubaté, São Paulo, Brazil.
Clin Exp Med. 2022 May;22(2):269-275. doi: 10.1007/s10238-021-00749-1. Epub 2021 Aug 4.
Hepatitis C virus has infected over 71 million people worldwide, and it is the main cause of cirrhosis in the western world. Currently, the treatment involves direct-acting antiviral agents (DAAs) and its main goal is to achieve sustained virologic response (SVR). The aim of this study was to evaluate the impact of SVR using DAAs in the improvement of liver fibrosis using scores evaluation by indirect method, liver function, and inflammation indirect biomarkers. Patients with cirrhosis with SVR after treatment (n = 104) were evaluated using liver function scores, indirect fibrosis methods, alpha-fetoprotein, and ferritin at t-base and t-SVR. Statistically significant positive results in all parameters were observed: 54 patients were classified as 5 in the CP score in t-base, and 77 in t-SVR; a significant decrease was observed in MELD score, alpha-fetoprotein, ferritin, APRI, FIB-4 and liver stiffness in liver elastography. We did not observe difference in the liver function scores between regressors and non-regressors of liver stiffness, as well as in indirect inflammation biomarkers. The measurements of fibrosis using the indirect methods have significantly decreased in patients with cirrhosis treated who achieved SVR associated with decreased indirect inflammation biomarkers and improved liver function scores.
丙型肝炎病毒已感染全球超过 7100 万人，是西方世界肝硬化的主要病因。目前，治疗方法包括直接作用抗病毒药物（DAA），其主要目标是实现持续病毒学应答（SVR）。本研究旨在通过间接方法的评分评估、肝功能和炎症间接标志物，评估 DAA 治疗后 SVR 对肝纤维化的改善情况。我们评估了治疗后 SVR 的肝硬化患者（n=104）的肝功能评分、间接纤维化方法、甲胎蛋白和铁蛋白在 t 基础和 t-SVR 时的水平。所有参数均观察到有统计学意义的阳性结果：54 例患者在 t 基础时 CP 评分中被分类为 5 分，而在 t-SVR 时为 77 分；MELD 评分、甲胎蛋白、铁蛋白、APRI、FIB-4 和肝脏弹性成像中的肝硬度显著降低。我们未观察到肝硬度的回归与非回归患者之间的肝功能评分以及间接炎症标志物之间存在差异。用间接方法测量的纤维化在实现 SVR 的肝硬化患者中显著降低，与间接炎症标志物降低和肝功能评分改善有关。
