Changes in liver stiffness and steatosis in children after successful treatment with sofosbuvir/velpatasvir: Results of the PANDAA-PED study.

Abstract

Aim of the study: The aim of this study was to analyze changes in liver stiffness and steatosis using noninvasive methods in children aged 6 to 18 years up to one year after successful treatment with sofosbuvir/velpatasvir (SOF/VEL).

Material and methods: Evaluation of liver stiffness and steatosis was performed in 49 patients at 12 weeks and one year after treatment using noninvasive methods. Liver stiffness measurement (LSM) and the controlled attenuation parameter (CAP) were obtained by transient elastography (FibroScan 530, Echosens).

Results: At baseline, LSM corresponded to a METAVIR F score of 0/1 in 48/49 (98%) participants. There was a decrease in mean LSM values from baseline to posttreatment visits (from 4.63 kPa to 4.26 kPa at 12 weeks, and 4.15 kPa at one year after treatment). In one girl who presented with significant fibrosis (LSM 11.3 kPa, F3) before the treatment, regression of stiffness was observed to 7.6 kPa (F2) at 12 weeks after treatment and 5.4 kPa (F0/1) at one year after treatment. There was an increase in the mean CAP value of +12.44 dB/m at 12 weeks after treatment compared to baseline, but the difference at one year after treatment was insignificant. A correlation between higher CAP values and older participants' age was observed at all the visits. Children with body mass index (BMI) z-score values > 1.0 presented with higher CAP values both before and after treatment.

Conclusions: Most children with chronic hepatitis C present with normal liver stiffness. However, its regression may occur to some extent after successful treatment with SOF/VEL. A transient increase in hepatic steatosis was observed after eradication of HCV, which requires further investigation.