title: Improvement of liver stiffness in patients with hepatitis C virus infection who received direct-acting antiviral therapy and achieved sustained virological response.
abstract: OBJECTIVE
  There is insufficient research on whether direct-acting antiviral (DAA) therapy can improve liver fibrosis in patients with chronic hepatitis C virus (HCV). We evaluated sequential changes in liver stiffness using shear wave elastography in patients with HCV who received DAA therapy.
  
  
  METHODS
  A total of 210 patients with HCV who received daclatasvir and asunaprevir therapy and achieved sustained virological response (SVR) were analyzed. Liver stiffness, as evaluated by shear wave elastography, and laboratory data were assessed before treatment (baseline), at end of treatment (EOT), and at 24 weeks after EOT (SVR24).
  
  
  RESULTS
  Alanine aminotransferase levels (ALT) decreased over time, and there were significant differences between baseline and EOT and between EOT and SVR24. Although platelet counts did not significantly differ between baseline and EOT, they increased significantly from EOT to SVR24. The median (interquartile range) liver stiffness values at baseline, EOT, and SVR24 were 10.2 (7.7-14.7), 8.8 (7.1-12.1), and 7.6 (6.3-10.3) kPa, respectively (P < 0.001, baseline vs EOT; P < 0.001, EOT vs SVR24). Additionally, in patients with ALT ≤ 30 (indicating low necroinflammatory activity in the liver) and Fibrosis-4 index > 2.0 (n = 75), the liver stiffness values at baseline, EOT, and SVR24 were 9.6 (7.7-15.2), 9.2 (7.3-12.1), and 7.7 (6.3-10.1) kPa, respectively (P < 0.001, baseline vs EOT; P < 0.001, EOT vs SVR24).
  
  
  CONCLUSIONS
  These results suggest that early improvement of liver stiffness starts during the administration of DAAs in patients who achieve SVR, and this effect is particularly pronounced in patients with progressive liver fibrosis.
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tada
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Mizuno
authors.affiliation: Department of Radiology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sone
authors.affiliation: Department of Imaging Diagnosis, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Saki
authors.initials: S
authors.lastname: Kataoka
authors.affiliation: Department of Imaging Diagnosis, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Hashinokuchi
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D002219:Carbamates; D004359:Drug Therapy, Combination; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D007546:Isoquinolines / Q000008:administration & dosage*; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D011759:Pyrrolidines; D013449:Sulfonamides / Q000008:administration & dosage*; D000072230:Sustained Virologic Response; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives
chemical_list: D000998:Antiviral Agents; D002219:Carbamates; D007093:Imidazoles; D007546:Isoquinolines; D011759:Pyrrolidines; D013449:Sulfonamides; D014633:Valine; C549273:daclatasvir; C571889:asunaprevir
keywords: direct-acting antiviral; hepatitis C; liver stiffness; shear wave elastography; sustained virological response