Impact of long-term eradication of chronic Hepatitis C infection using the direct-acting antiviral treatment on liver fibrosis parameters in Egyptian patients

Background: Hepatitis C virus (HCV) treatment aims to halt the progression of fibrosis and reducing its complications. HCV-treatment has been enhanced by the development of all-oral DAAs with good efficacy and a reasonable side effect. Aims: The goal of this study is to see how long-term eradication of HCV affect liver fibrosis following DAAs therapy. Materials and methods: 500 HCV patients receiving sofosbuvir-based therapy with daclatasvir or ledipasvir (with or without ribavirin). In addition to clinical, laboratory, and radiological examination, FIB-4, APRI, Fibroscan examination, Child and MELD scores were calculated at baseline and one year after end of therapy (EOT). Results: Out of 500 participants included in the study, 493 participants complete the study period. 454 (92.1%) patients had sustained virologic response (SVR) during the period of study and 39 patients were non-responders. In patients with SVR, FIB-4 index, APRI score and fibroScan measures showed significant reduction one-year post-EOT versus baseline (p < 0.001 for all). Although, Child score in patients had SVR did not demonstrate a significant improvement one year after EOT versus baseline (p = 0.479), it showed a significant improvement versus non responder (p < 0.001). In addition, MELD score revealed a significant reduction in patients who achieved SVR one-year post-EOT versus baseline (p = 0.028). Furthermore, one-year following EOT, there was a significant improvement in MELD score in patients with SVR versus non-responder (p < 0.001). Conclusion: DAAs therapy in HCV-related liver disease had a good impact on liver fibrosis regression and the improvement of its outcome.