Fibroscan as Non Invasive Modality for Studying the Effect of Hepatic Steatosis on Viral Response to Direct – Acting Antiviral in Patients with Chronic Hepatitis C

Abstract

CV is a major cause of viral hepatitis leading to chronic liver disease and liver failure. With an estimated prevalence of 3% in the world population (around 170 million infected individuals worldwide), HCV heavily burdens public health. Even though the incidence of new infections is declining, at least in industrialized countries where they are restricted to intravenous drug users, morbidity and mortality associated with HCV infection are expected to increase over the next decade. Steatosis is a benign and reversible condition. However, in a few cases, Steatosis is associated inflammation and hepatocyte changes, and is then defined as steatohepatitis. Steatosis can also be a co-factor in many chronic liver diseases that can lead to fibrosis, cirrhosis and rapid progreassion of the course of the disease. The gold standard for diagnosis of hepatic steatosis is liver biopsy which is an invasive method with some limitations. Recently, controlled attenuation parameter (CAP) has been introduced to detect and quantify hepatic steatosis. CAP measures the ultrasonic attenuation in the liver tissue depending on the viscosity [fat] of the medium [liver] and the distance of propagation of the ultrasonic signals into the liver. NAFLD was defined by CAP values ≥ 216 dB/m.