Predictors of liver fibrosis changes assessed by paired liver biopsies in chronic hepatitis C patients treated with direct-acting antivirals

Abstract

Abstract Background/Purpose: There are limited studies performing paired liver biopsies in chronic hepatitis C (CHC) patients treated with direct-acting antivirals (DAA).We aimed to investigate the predictors of liver fibrosis changes assessed by paired liver biopsies in these patients. Methods: From March 2017 to March 2020, 113 CHC patients were prospectively enrolled to receive DAA therapy at our hospital. Paired liver biopsies were performed at baseline and 12 weeks after the end of treatment. Results: Among the entire cohort, the rate of sustained virological response (SVR) was 100%. Four baseline variables independently predicted fibrosis regression, including age<65 years [odds ratio (OR)Z2.725, pZ0.036], fibrosis stages (METAVIR scores) < 3 (ORZ4.874, pZ0.040), hemoglobin levels 12.5 g/dL (OR Z 3.538, p Z 0.029), and platelet counts 160 103/mL (OR Z 2.958, p Z 0.023). Besides, five independent predictors of fibrosis progression included baseline age 66 years (OR Z 16.351, p Z 0.024), body mass index (BMI) 26.5 kg/m2 (OR Z 21.666, p Z 0.009), sofosbuvir/ribavirin use (OR Z 29.465, p Z 0.031), platelet counts <119 103/mL (ORZ33.739, pZ0.026), and the absence of alanine aminotransferase (ALT) levels declining from >35 U/L at baseline to 35 U/L at 4 weeks after baseline (OR Z 284.534, p Z 0.026).