Department of Internal Medicine, SoonChunHyang University School of Medicine, Digestive Disease Center and Research Institute, SoonChunHyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, 14584, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Yonsei Liver Center, Severance Hospital, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
Sci Rep. 2022 Jan 7;12(1):193. doi: 10.1038/s41598-021-03272-1.
We prospectively investigated the changes of liver stiffness (LS) and the occurrence of hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) eradication using direct antiviral agents (DAA) over three years. LS measurement using transient elastography and serum fibrosis surrogate markers before treatment and at 48, 96, 144 weeks after starting direct-acting antivirals (DAA) according to the protocol were evaluated. Patients were also compared with historical cohort treated with pegylated interferon (peg-IFN). Sustained viral response (SVR) was observed in 95.8%. LS value in the patients achieving SVR significantly decreased over time (19.4 ± 12.9 kPa [baseline], 13.9 ± 9.1 kPa [48 weeks], 11.7 ± 8.2 kPa [96 weeks], 10.09 ± 6.23 [144 weeks], all p < 0.001). With matched analysis, the decrease in LS value was significantly larger in DAA group than peg-IFN group at both 48 weeks (29% vs. 9%) and 96 weeks (39% vs. 17%). The incidence of HCC was not significantly different between DAA and peg-IFN groups (5.5% vs. 5.4%) at 144 weeks. HCV eradication with DAA can lead to improvement of liver stiffness over time. The regression of fibrosis was greater in the group with DAA than peg-IFN.Clinical trials registration: ClinicalTrials.gov (NCT02865369).
我们前瞻性地研究了使用直接抗病毒药物 (DAA) 在三年内 HCV 根除后肝硬度 (LS) 的变化和肝细胞癌 (HCC) 的发生。根据方案，在治疗前和开始直接作用抗病毒药物 (DAA) 后 48、96 和 144 周使用瞬时弹性成像和血清纤维化替代标志物测量 LS，并将患者与用聚乙二醇干扰素 (peg-IFN) 治疗的历史队列进行比较。95.8%的患者获得持续病毒学应答 (SVR)。获得 SVR 的患者的 LS 值随时间显著降低（19.4 ± 12.9 kPa [基线]、13.9 ± 9.1 kPa [48 周]、11.7 ± 8.2 kPa [96 周]、10.09 ± 6.23 kPa [144 周]，均 p < 0.001）。通过匹配分析，在第 48 周和第 96 周时，DAA 组的 LS 值下降幅度明显大于 peg-IFN 组（29% vs. 9%和 39% vs. 17%）。在 144 周时，DAA 和 peg-IFN 组 HCC 的发生率无显著差异（5.5% vs. 5.4%）。DAA 根除 HCV 可导致 LS 随时间改善。DAA 组的纤维化消退大于 peg-IFN 组。临床试验注册：ClinicalTrials.gov（NCT02865369）。
