Study of the Effect of Directly Acting Antiviral Drugs (DAA) on Hepatic Fibrosis Using APRI Score and FIB4 Score in Chronic Hepatitis c Patients (HCV)

Abstract

H epatitis C virus is a major health hazard in Egypt. HCV-related morbidity and mortality is a main health issue facing the Egyptian ministry of health. Hepatic fibrosis is one of the most important inciting factors to most of HCV chronic infection related morbidity and mortality. Fibrosis and subsequent cirrhosis is lengthy process that needs years to develop. This process is also potentially reversible over time with treatment of HCV infection. In this study we used hepatic fibrosis scores (APRI & FIB-4) to assess hepatic fibrosis after receiving DAA drugs for chronic hepatitis c virus infection in patients reaching SVR. The study included 100 subjects who were classified into 2 groups, according to their initial laboratory and sonographic data, to either Cirrhotic patients or non cirrhotic patients. Patients were allocated to their treatment groups (SOF,DACLA- SOF,SIM- SOF,DACLA,RIBA) according to availability from supplying facility and all were followed up for 6 months after finishing treatment. In this study statistical analysis of data showed improvement of liver functions Albumin, Bilirubin & INR in the cirrhotic group after clearing the virus at end of treatment, after 3 months post treatment and after 6 months post treatment. Comparison between APRI (AST to platelet ratio) in each individual group revealed regression of APRI score in both groups slightly in the non cirrhotic group with improvement of platelet count and ALT & AST after receiving appropriate treatment.