IMPROVEMENT IN LIVER STIFFNESS IN PEDIATRIC HCV PATIENTS AFTER TREATMENT WITH DIRECT ACTING ANTIVIRALS

作者：Engy A. Mogahed MD^*; Hanaa El-Karaksy MD; Hala Abdullatif MD; Noha A. Yasin MD; Ahmed Nagy MD; Shereen Abdel Alem MD; Hadeel Gamal Eldeen MD; Mona S. El-Raziky MD

来源：Journal of Pediatrics, 2021.

DOI：10.1016/j.jpeds.2021.02.012

• APRI
• children
• direct acting antivirals
• FIB-4
• fibrosis
• hepatitis C virus
• liver stiffness
• sustained virologic response
• transient elastography
• treatment

ObjectivesTo assess the degree of liver stiffness using transient elastography (TE) in hepatitis C virus (HCV) infected Egyptian children at baseline and one-year after achievement of sustained virologic response (SVR) with direct acting antivirals (DAAs).Study designThis prospective study included HCV infected children who received treatment with sofosbuvir/ledipasvir and achieved SVR. At baseline and one-year after achievement of SVR, the extent of hepatic fibrosis was assessed by TE using FibroScan to measure liver stiffness, in addition to non-invasive markers including aspartate aminotransferase (AST)/platelet ratio index (APRI) and Fibrosis-4 (FIB-4) index.ResultsThe study included 23 cases that had variable degrees of fibrosis at baseline; their ages ranged between 10-18 years. At baseline, 13 patients had F1, 3 patients had F1-F2, 1 patient had F2, 3 patients had F3, 2 had F3-F4 and 2 patients with F4. One-year after achievement of SVR, there was a statistically significant improvement in liver stiffness, APRI and FIB-4 index (P = .03, <0.001, 0.02 respectively). In 13 patients (56.5%), the liver stiffness improved, in 7 patients it was stationary, and the remaining 3 patients showed mild increase in liver stiffness that was, however, associated with improvement in APRI and FIB-4 index. Co-morbid conditions and previous treatment with interferon were not associated with increased liver stiffness one-year after SVR.ConclusionsEgyptian children infected with HCV GT4 achieved significant regression in liver stiffness after treatment with DAAs.