Changes in Liver Stiffness and Steatosis in Patients with Chronic Hepatitis C during the Clinical Course of Daclatasvir/ Velpatasvir Therapy: A Prospective Observational Study
Changes in Liver Stiffness and Steatosis in Patients with Chronic Hepatitis C
Background: The mechanism behind reduction of liver fibrosis and steatosis in Chronic Hepatitis C (CHC) patients receiving interferon-free Direct Acting Antiviral Agent (DAA) therapy is still unclear. Non-invasive techniques such as Transient Elastography (TE) and Controlled Attenuation Parameter (CAP) are used to evaluate the chronological changes in liver stiffness and steatosis, respectively, in CHC patients receiving DAA therapy. Subjects and Methods: The study involves 50 CHC patients receiving Daclatasvir or Velpatasvir (DCV/VEL) in whom liver stiffness and steatosis was measured using TE and CAP, respectively. Laboratory investigational data, liver stiffness, and steatosis were recorded at baseline (prior to therapy), week 12 (post initiation of therapy), End of Treatment (EOT), and week 24 (post initiation of therapy). Analysis was performed 12 weeks post completion of therapy (SVR 12). Results: Significant difference was observed in laboratory parameters such as aminotranferases, serum albumin, platelet count, and α-fetoprotein at each time point of study as compared to the baseline. A highly statistically significant difference was observed in laboratory parameters when calculated as overall (P<0.001). Liver stiffness reduced significantly at baseline vs week 12 (P=0.044), week 12 vs EOT (P=0.011), baseline vs week 24 (P<0.001) (overall P<0.001). However, steatosis showed an insignificant difference (overall P=0.325). Conclusion: A signiﬁcant overall decrease was observed in liver stiffness among patients with chronic hepatitis C during the clinical course of Daclatasvir/ Velpatasvir therapy. Steatosis reduced considerably, however the results were found to be statistically insignificant.