IMPACT OF DIRECT-ACTING ANTIVIRALS ON THE FIB-4 INDEX IN PATIENTS WITH CHRONIC HEPATITIS C AND SUSTAINED VIROLOGICAL RESPONSE.

Abstract

Introduction and Objectives

Fibrosis regression is associated with broad clinical benefits and remains an important therapeutic goal in patients with advanced fibrosis who achieve a sustained virological response (SVR) to hepatitis C virus (HCV) treatment. Studies conducted in Asia have reported fibrosis regression in 55% to 75% of patients. Currently, there are no published reports from studies conducted in our country.

Evaluate the impact of direct-acting antiviral (DAA) therapy on the Fib-4 index in patients with chronic hepatitis C who achieved a sustained virological response (SVR).

Materials and Methods

Patients were classified into two groups: non-cirrhotic (n=28) and cirrhotic (n=62). Pre- and post-treatment Fib-4 index values were collected and compared. The Wilcoxon signed-rank test, a non-parametric test, was used to compare pre- and post-treatment Fib-4 scores within each group. The Mann-Whitney U test was applied to compare whether the magnitude of change in the Fib-4 score differed between the non-cirrhotic and cirrhotic groups. A p-value of ≤ 0.05 was considered statistically significant.

Results

Both groups experienced a statistically significant reduction in post-treatment Fib-4 scores (p<0.001). The magnitude of this reduction was significantly greater in the group of patients with cirrhosis compared to those without cirrhosis (p = 0.027). (See Figure 1).

Our study demonstrates that successful DAA therapy leads to a statistically significant reduction in the Fib-4 index in a Mexican cohort of patients with chronic HCV, a finding that is consistent with reports from other regions. This reduction in a key non-invasive marker suggests a regression of liver fibrosis or, at a minimum, a significant decrease in necroinflammatory activity upon viral eradication.

Conclusions

DAA therapy significantly reduces the Fib-4 score in patients with chronic HCV, regardless of the presence of cirrhosis. This demonstrates a favorable impact, thereby improving the prognosis for these patients.