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Longitudinal assessment of hepatic fibrosis in responders to direct‐acting antivirals for recurrent hepatitis C after liver transplantation using noninvasive methods
Author(s) -
Omar Heba,
Said Mohamed,
Eletreby Rasha,
Mehrez Mai,
Bassam Mohamed,
Abdellatif Zeinab,
Hosny Adel,
Megawer Sherif,
El Amir Mona,
Yosry Ayman
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13334
Subject(s) - medicine , gastroenterology , fibrosis , liver transplantation , hepatic fibrosis , hepatitis c virus , hepatitis c , transplantation , immunology , virus
Successful eradication of recurrent hepatitis C virus ( HCV ) infection following liver transplantation ( HCV ) improves graft survival. This study aimed at evaluation of hepatic fibrosis changes among long‐term responders to DAA therapy for recurrent HCV after liver transplantation using noninvasive methods. Patients with significant hepatic fibrosis (≥F2) who achieved SVR 12 after treatment with DAA s for recurrent HCV were included (n = 52). Hepatic fibrosis status was assessed, noninvasively, by calculation of fibrosis‐4 score ( FIB ‐4) and Aspartate Aminotransferase Platelet Ratio Index ( APRI ) and by measurement of graft stiffness using FibroScan at baseline and 12 and 18 months post‐treatment. Acoustic radiation force imaging ( ARFI ) was done for all patients 12 and 18 months post‐treatment. Patients were classified into two groups based on baseline liver stiffness measurement ( LSM ) by FibroScan; significant fibrosis (F2; n = 28) and advanced fibrosis groups (≥F3). Over 18‐month follow‐up period, there was serial improvement of FIB ‐4, APRI , and LSM by FibroScan in both groups. Higher baseline LSM and delayed initiation of antiviral therapy were significant predictors of lack of fibrosis regression ( P ‐value 0.01 and 0.04, respectively). Fibroindices and LSM improved over time in liver transplant recipients who responded to DAA s. Baseline LSM can predict post‐treatment fibrosis regression.