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“In summary, this study showed an “overall 60% improvement in subjects with baseline cirrhosis or advanced fibrosis after achieving SVR based on FibroScan,” the researchers concluded, suggesting that APRI might be used to predict regression in people with advanced fibrosis.”
A majority of people with chronic hepatitis C and advanced fibrosis or cirrhosis showed improvement in liver health following treatment, according to study findings presented last week at the 2015 AASLD Liver Meeting in San Francisco, USA. However, the researchers identified few demographic, laboratory or disease-related factors that could predict who would experience fibrosis regression and who would have worsening liver damage.
Over years or decades, chronic hepatitis C virus (HCV) infection can lead to advanced liver disease including cirrhosis, liver cancer and liver failure requiring a transplant.
Prior studies have shown that treatment with interferon-based therapy for hepatitis C, as well as tenofovir (Viread) for hepatitis B, can lead to some reversal of fibrosis and reduced risk of hepatocellular carcinoma and liver-related death. Direct-acting antiviral agents used in interferon-free regimens can now cure upwards of 90% of people with hepatitis C, but it is not yet known how treatment response will be reflected in long-term clinical outcomes.
Among the 35 participants who had advanced fibrosis at baseline, 69% demonstrated improvement according to FibroScan, 14% remained unchanged and 17% worsened to cirrhosis. Among the 65 people with cirrhosis at baseline, 55% showed improvement and 45% remained unchanged. Taken together, 60% improved, 34% had no change and 6% worsened.
Median time to improvement was 2.5 years for people with advanced fibrosis and 3.0 years for those with cirrhosis at baseline, indicating that those with less severe liver injury improved faster.