Modification of liver fibrosis,glucose and lipid profile after hepatitis C virus clearance with direct-acting antiviral agents |
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| Institution: | 1. Department of Gastroenterology and Hepatology, Navarra Hospital Complex, Pamplona, Spain;2. Instituto de Salud Pública de Navarra, Pamplona, Spain;3. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain;4. CIBER Epidemiología y Salud Pública, Spain;5. Liver Unit, Clínica Universidad de Navarra, Pamplona, Spain;6. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain;1. Department of Hepatobiliary Surgery II, State Key Laboratory of Organ Failure Research, Guangdong Provincial Research Center for Artificial Organ and Tissue Engineering, Guangzhou Clinical Research and Transformation Center for Artificial Liver, Institute of Regenerative Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China;2. General Surgery Department, The Second Hospital of Shenzhen Baoan People''s Hospital Group, Shenzhen 518108, Guangdong Province, China;1. Department of Infectious Diseases, First Affiliated Hospital of Nanchang University, Jiangxi, China;2. Key Laboratory of Liver Regeneration Medicine, Jiangxi, China;3. Department of Ultrasound, Jing Zhou Central Hospital, Hubei, China;4. Department of Infectious Diseases, Ganzhou People''s Hospital, Jiangxi, China;5. Zhejiang University School of Medicine, First Affiliated Hospital, Zhejiang, China;1. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Arnau de Vilanova, Lleida, España;2. Unidad de Coloproctología, Hospital Universitario Arnau de Vilanova, Lleida, España;3. Servicio de Anatomía Patológica, Hospital Universitario Arnau de Vilanova, Lleida, España |
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| Abstract: | IntroductionThere is little information on whether direct-acting antiviral (DAA) treatment can improve liver fibrosis or change glucose and lipid profile in patients with chronic hepatitis C (CHC). We aimed to evaluate the impact of sustained virologic response (SVR) on liver stiffness, glucose and lipid levels.Methods445 monoinfected CHC patients started treatment with interferon-free DAA therapy from January 2015 to February 2017. Transient elastography (TE), fibrosis scores, glucose and lipid levels were analyzed at baseline and 48 weeks post-treatment (SVR48).ResultsThe SVR rate was 97.7%. Finally, we evaluated 369 patients who achieved SVR and had reliable TE measurements. Median liver stiffness significantly decreased from 9.3 (IQR 7.3–14.3) kPa at baseline to 6.4 (IQR 4.9–8.9) at SVR48 (p < 0.0001). 54.7% of the cohort presented fibrosis regression. Median FIB4 score regressed from 2.0 (IQR 1.1–3.3) to 1.3 (IQR 0.9–2.0) (p < 0.0001). Median APRI and Forns values significantly decreased from 0.9 (IQR 0.5–1.7) to 0.3 (IQR 0.2–0.4) and from 6.2 (5.0–7.5) to 4.9 (IQR 3.8–5.9) (p < 0.001), respectively. Mean levels of total cholesterol and LDL-C increased from 172 mg/dL and 101.5 mg/dL to 191 mg/dL and 117.5 mg/dL (p < 0.0001), respectively. In the sub-group of patients with pre-diabetes or diabetes, mean glucose levels decreased from 142.7 mg/dL at baseline to 127.2 mg/dL at SVR48 (p < 0.001).DiscussionSVR reduces liver stiffness based on TE and fibrosis scores, in patients treated with DAA. Our results show elevated total cholesterol and LDL-C and decreased glucose levels at SVR48. |
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| Keywords: | Direct acting antiviral Hepatitis C virus Transient elastography Fibrosis scores Glucose Lipid profile Antivirales de acción directa Virus de la hepatitis C Elastografía Marcadores serológicos Glucosa Perfil lipídico |
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