An Evaluation of Chronic Hepatitis C Patients' Responses to Direct-Acting Antivirals According to Transient Elastography and Serum Biomarkers

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 (DM) 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 4s . 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.