Abstract:

Objectives: In this study, it was evaluated the changes in liver stiffness measurements measured by AST to Platelet Ratio index (APRI), Fibrosis 4 index (FIB-4), Age Platelet index (API), AST-ALT ratio (AAR) and transient elastography (TE) among the non-invasive fibrosis scores in chronic hepatitis C (CHC) patients treated with direct-acting agents (DAA) and the effect of treatment. Materials and Methods: Ombitasvir-paritaprevir-ritonavir-dasabuvir ± ribavirin (RBV) or sofosbuvir ± ledipasvir (SOF ± LDV) ± RBV was given to the patients. Fibrosis scores were calculated with the biochemical data of the patients before the treatment, at the 4th week of the treatment, at the end of treatment and at the sustained virological response 12 (SVR12). Liver stiffness measurements were recorded before treatment with TE and in SVR12. Post-treatment SVR12 responses were evaluated. Results: SVR12 was achieved in 97.9% of 95 patients included in the study. Significant regression was found in APRI and FIB-4 scores, which are among the 4 serum fibrosis markers calculated in all patients (p<0.001, p<0.001). Liver stiffness was measured using TE in 75 patients. It was determined that the liver stiffness measurement (9.3±6.5 kPa) in SVR12 significantly decreased compared to the baseline (11.6±7.8 kPa) (p<0.001). Conclusion: DAA provides improvement in fibrosis scores and persistent viral response in patients. In our study, in which fibrosis was evaluated non-invasive methods, it was observed that there was a significant improvement in liver fibrosis with APRI, FIB-4 and TE measurements.

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