title: Serum Biomarkers Indicate Long-term Reduction in Liver Fibrosis in Patients With Sustained Virological Response to Treatment for HCV Infection.
abstract: Sustained virological response (SVR) to antiviral therapy for hepatitis C virus (HCV) correlates with changes in biochemical measures of liver function. However, little is known about the long-term effects of SVR on liver fibrosis. We investigated the effects of HCV therapy on fibrosis, based on the Fibrosis-4 (FIB4) score, over a 10-year period.
  
  
  
  We collected data from participants in the Chronic Hepatitis Cohort Study-a large observational multicenter study of patients with hepatitis at 4 US health systems-from January 1, 2006, through December 31, 2013. We calculated patients' FIB4 score and the aminotransferase-to-platelet ratio index (APRI) score over a 10-year period. Of 4731 patients with HCV infection, 1657 (35%) were treated and 755 (46%) of these patients achieved SVR.
  
  
  
  In propensity score-adjusted analyses, we observed significant longitudinal changes in FIB4 score that varied with treatment and response to treatment. In patients achieving SVR, FIB4 scores decreased sharply, remaining significantly lower over the 10-year period than in untreated patients or patients with treatment failure (P < .001). In independent analyses, men and patients with HCV genotype 1 or 3 infections had higher FIB4 scores than women or patients with HCV genotype 2 infections (P < .01 for both). Findings were similar in a sensitivity analysis that substituted the APRI as the marker of fibrosis instead of the FIB4 score.
  
  
  
  SVR to HCV treatment appears to induce long-term regression of fibrosis based on FIB4 scores collected over 10 years from a large observational study of US hepatitis patients. Patients receiving no treatment or with treatment failure had progressive increases in FIB4 scores.
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan. Electronic address: mlu1@hfhs.org.
authors.forename: Mei
authors.initials: M
authors.lastname: Lu
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
authors.forename: Talan
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan.
authors.forename: Loralee B
authors.initials: LB
authors.lastname: Rupp
authors.affiliation: Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan.
authors.forename: Sheri
authors.initials: S
authors.lastname: Trudeau
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Holmberg
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Moorman
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Spradling
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Eyasu H
authors.initials: EH
authors.lastname: Teshale
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Fujie
authors.initials: F
authors.lastname: Xu
authors.affiliation: Center for Health Research, Geisinger Health System, Danville, Pennsylvania.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Boscarino
authors.affiliation: Center for Health Research, Kaiser Permanente-Northwest, Portland, Oregon.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Schmidt
authors.affiliation: Center for Health Research, Kaiser Permanente-Hawai'i, Waipahu, Hawaii.
authors.forename: Vinutha
authors.initials: V
authors.lastname: Vijayadeva
authors.affiliation: Division of Gastroenterology and Hepatology, Henry Ford Health System, Detroit, Michigan.
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Gordon
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D044967:Serum / Q000737:chemistry*; D000072230:Sustained Virologic Response; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers
keywords: CHeCS; Fibrosis Progression; Growth Curve Analysis of Trajectory; Outcome