title: Analysis of effect of antiviral therapy on regression of liver fibrosis in patient with HCV infection.
abstract: BACKGROUND
  HCV infection is characterized by a tendency towards chronicity. Acute HCV infection progresses to chronic infection in 70% of cases. Hepatitis C virus infection can cause progressive liver injury and lead to fibrosis and eventually cirrhosis. The degree of histologic fibrosis is an important marker of the stage of the disease. One of current standard treatment for CHC infection is the combination of PEG-IFN α and ribavirin.
  
  
  OBJECTIVE
  The aim of the study was to investigate the effect of the therapy with Peginterferon alfa-2a or alfa-2b plus Ribavirin on evolution of liver fibrosis in patients with chronic hepatitis C. Also, our aim was to examine whether there was a difference between the genders in the efficacy of these antiviral therapy. Our goal also was to determine effect of the therapy with Peginterferon alfa-2a or alfa-2b plus Ribavirin on evolution of liver steatosis in patients with chronic hepatitis C.
  
  
  METHODS
  A retrospective study was made of chronic hepatitis C patients who had been treated from 2005 to April 2014 at the Clinic of Gastroenterohepatology, Clinical Center University of Sarajevo. We reviewed 40 patient medical records to collect demographic, epidemiological and clinical information, as information on liver biopsies that was performed prior to the antiviral therapy and FibroScan(®) test that was performed after the antiviral therapy. For the processing of data SPSS (Statistical Package for the Social Sciences Program) for Windows, ver. 21.0 statistical software was used. Comparisons between qualitative and quantitative variables were performed using the Student t-test. Mann Whitney U test was used to compare differences in variables such as fibrosis stage and steatosis grade. A value of p<0.05 was considered as statistically significant.
  
  
  RESULTS
  After treatment, there was a statistically significant increase in the number of patients with no fibrosis (p<0.05). There was no statistically significant reduction in the number of patients with cirrhosis (F4) (p>0.05). There was significantly higher decrease of fibrosis progression at the patients that were in an mild-to-moderate fibrosis (F1/F2/F3), patients that were in advanced stage of fibrosis (F4) at the time of the pre-treatment did not have a statistically significant fibrosis reduction. We found significant association in evolution of fibrosis after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2a (12,5) kD with ribavirin (p< 0.05). We also found significant association in evolution of steatosis after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2a (12,5) kD with ribavirin (p < 0.05). There was statistically significant differences (p<0.05) between genders within fibrosis qualitative evolution.
  
  
  CONCLUSIONS
  There were significant regression of fibrosis especially at the patients that were in an mild-to-moderate fibrosis (F1/F2/F3), patients that were in advanced stage of fibrosis (F4) at the time of the pre-treatment did not have a statistically significant fibrosis reduction after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2b (12,5) kD with ribavirin. Our results showed significant improvement in steatosis in patients infected with HCV after treatment with PEG-IFN α2a (40) kD and PEG-IFNα2b (12,5) kD with ribavirin. Those results provides further evidence for direct involvement of HCV and antiviral therapy in the pathogenesis of hepatic steatosis. Female gender showed a higher degree of fibrosis reduction.
authors.affiliation: Gastroenterohepatology department, Clinical Center of Sarajevo, University Sarajevo, Bosnia and Herzegovina.
authors.forename: Zora
authors.initials: Z
authors.lastname: Vukobrat-Bijedic
authors.affiliation: Gastroenterohepatology department, Clinical Center of Sarajevo, University Sarajevo, Bosnia and Herzegovina.
authors.forename: Azra
authors.initials: A
authors.lastname: Husic-Selimovic
authors.affiliation: Pathology Department, Clinical Center of Sarajevo, University Sarajevo, Bosnia and Herzegovina.
authors.forename: Lejla
authors.initials: L
authors.lastname: Mehinovic
authors.affiliation: Gastroenterohepatology department, Clinical Center of Sarajevo, University Sarajevo, Bosnia and Herzegovina.
authors.forename: Amila
authors.initials: A
authors.lastname: Mehmedovic
authors.affiliation: Urology department, Clinical center of Sarajevo University, Sarajevo, Bosnia and Herzegovina.
authors.forename: Dzelaludin
authors.initials: D
authors.lastname: Junuzovic
authors.affiliation: Faculty of Information Technologies, University "Dzemal Bijedic" Mostar, Bosnia and Herzegovina.
authors.forename: Ivana
authors.initials: I
authors.lastname: Bjelogrlic
authors.affiliation: Radiology Department, Clinical center of Sarajevo, University Sarajevo, Bosnia and Herzegovina.
authors.forename: Amela
authors.initials: A
authors.lastname: Sofic
authors.affiliation: CHC Lukavica, East Sarajevo, Bosnia and Herzegovina.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Djurovic
keywords: Antiviral Therapy; Regression