Evaluation of liver fibrosis by FIB-4 Index before and after Sofosbuvir in Egyptian Patients with chronic HCV

Abstract

Abstract Introduction: Hepatitis C Virus (HCV) is a serious global health problem. HCV leads to permanent liver damage which may progress to hepatocellular carcinoma. Treatment of HCV had changed markedly in the last years. Measuring the degree of liver stiffness is a mandatory step before treatment initiation.Fibrosis-4 index (FIB-4) is a non-invasive method to measure the degree of liver fibrosis. Aim: To evaluate the role of FIB-4 index before and after Sofosbuvir- based treatment regimens either Dual (Sofosbuvir, Ribavirin) or Triple regimen(Sofosbuvir, Ribavirin &Pegylated Interferone α [Peg-INF α]). Method: This study enrolled 152 Egyptian patients with chronic HCV who received either dual or triple treatment regimen upon which they had been divided into triple and dual group. All patients were subjected to full clinical and laboratory examination, complete history taking, abdominal ultrasound, Fibroscan (Transient Elastography) before starting treatment and calculating FIB-4 index before and after treatment. Results: After treatment FIB-4 decreased significantly in dual group with mean ±SD(2.24± 1.56)before treatment and (1.54 ± .84) after treatment(p=0.000),while it changed with mild significance in triple group(p=0.047). Age in the triple group with mean ±SD(47.58± 9.78) was lower than dual group with mean ±SD (55.00± 6.99) which was highly statistically significant(p=0.000).Real time-Polymerase Chain Reaction (PCR) for HCV, Platelets count, Hemoglobin level and liver function changed with highly statistically significance (p=0.000 for all) while there was no significant changes had occurred concerning Total bilirubin nor Serum Creatinine in both groups after treatment. Conclusion: FIB-4 is a good noninvasive method to assess the degree of liver fibrosis with the aid of other radiological techniques, also there was a good response to treatment with both triple and dual regimens.