Study of Transient Elastography Changes and Biochemical Effects of Direct Acting Antiviral Regimens in Egyptian HCV Patients

Omar Mahmoud Azzam, MD of Internal Medicine, Ahmed Maher Teaching HospitalFollow
Nageh Kamal Georgy, M.Sc of Tropical Medicine, Ahmed Maher Teaching Hospital
Hesham Mohamed Elwakeel, MD of Tropical Medicine, Ahmed Maher Teaching Hospital

Article Type

Original Study

Subject Area

Internal Medicine

Abstract

Background: In 2014–2015, a new era in the clinical practice of managing chronic HCV using direct antiviral drugs (DAAs) began. The results of DAAS therapy are promising, with higher sustained virological response (SVR) rates, shorter, more efficient regimens, and less treatment-related side effects in HCV patients. For many years, the field of liver specialists has focused most of its study and debate on the retrogradation of liver fibrosis. Recent evidence, however, has shown that fibrosis decline occurs in a variety of chronic liver disorders, including persistent viral hepatitis.

Objective: to assess the biochemical effects of various DAAS regimens and changes in transient elastography results in individuals with chronic liver disease caused by HCV.

Methods: This research involved 100 Egyptian patients with chronic hepatitis C who were treated at the Ahmed Maher Teaching Hospital's Viral Hepatitis Unit.

Results: Over the course of the study, there were statistically significant changes in the liver profile of the group under investigation. Significant progress is shown following SVR1 and SVR2. Additionally, there is a discernible improvement in the tested population's grade of fibrosis as determined by TE measurements. After three months (SVR1), 2% of patients and twelve percent of patients after six months (SVR2), respectively, showed a significant regression from F4 to F3. Before therapy, the proportion of patients with F0 (no fibrosis) was 4%; after three months (SVR1) and six months (SVR2), it was 14% and 18%, respectively. Improvements in the FIB-4 score were highly statistically significant during the trial's duration. Patients with F4 grade fibrosis saw significant improvements in their scores; after SVR1 and SVR2, respectively, their percentage dropped from 56% prior to treatment to 42% and 38%. Fib-4 had a sensitivity of 50%, specificity of 92.9%, PPV of 94.7%, NPV of 41.9%, and accuracy of 62% when it came to predicting TE measurements. When predicting TE readings, the APRI score's sensitivity was 86.1%, specificity was 64.3%, PPV was 86.1%, NPV was 64.3%, and accuracy was 80%. When it came to predicting liver fibrosis, TE measurements showed a 72% sensitivity and a 38% sensitivity for FIB-4. The sensitivity rate increased to 74% when liver fibrosis was predicted using the FIB-4 score in addition to TE measurements. The percentage of sensitivity rose to 82% when we used the APRI score and TE measurements.

Conclusion: For many years, the field of liver specialists has focused most of its study and debate on the retrogradation of liver fibrosis. Transient elastography and other non-invasive fibrosis scores like FIB-4 and APRI show significant improvements in hepatic fibrosis measurements after DAAS-based treatment. Improvements in liver functions were linked to improvements in fibrosis scores, suggesting a notable reduction in the necro-inflammatory response.

IRB Number

HAM00199

Keywords

Chronic Liver Disease; DAAS; HCV; Transient Elastography

Recommended Citation

Azzam, Omar Mahmoud; Georgy, Nageh Kamal; and Elwakeel, Hesham Mohamed (2024) "Study of Transient Elastography Changes and Biochemical Effects of Direct Acting Antiviral Regimens in Egyptian HCV Patients," Journal of Medicine in Scientific Research: Vol. 8: Iss. 2, Article 3.
DOI: https://doi.org/10.59299/2537-0928.1420