Aralik 2022
Direkt etkili antiviral ajanlarla tedavi olan hepatit C hastalarinda non-invaziv fibrozis indeks degerlerinin degisimi
The changing non-invasive fibrosis index value in patients with hepatitis C treated with direct-acting antiviral agent
- Ana Sayfa
- Sayılar
- Aralik 2022
- Direkt etkili antiviral ajanlarla tedavi olan hepatit C hastalarinda non-invaziv fibrozis indeks degerlerinin degisimi...
Department of 2Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
Department of 3Gastroenterology, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Özet
Giris ve Amaç: Her yil yaklasik 400 000 hepatit C virüs hastasi siroza bagli komplikasyonlardan ve hepatosellüler karsinomadan ölmektedir. Dogrudan etkili antiviraller, hepatit C virüs enfeksiyonu olan hastalarin %90’indan fazlasinda sürekli bir virolojik yanit saglar. Bu çalismada dogrudan etkili antivirallerle tedavi edilen hepatit C virüslü hastalarda non-invaziv fibrozis indeksindeki degisikligi degerlendirmeyi amaçladik. Gereç ve Yöntem: Dogrudan etkili antiviral teadavisi alan hepatit C virüslü hastalar analiz edildi. Her hasta için FIB-4 ve APRI hesaplandi. Bulgular: Toplam 88 hastanin 46’si (%52) erkek, 21’i (%23.8) sirotikti. Ortalama yas 58 yil idi. Baslangiçtan tedavi bitimine kadar non-invaziv skorlarda anlamli düsüs gösterildi (p < 0.001). Baslangiçtan sürekli bir virolojik yanit sonrasina kadar ortalama FIB-4 ve APRI skorlarinda istatistiksel olarak anlamli bir düsüs vardi (p < 0.001). Uzun süreli takipte, sürekli bir virolojik yanit sonrasi 15 ayda düsük FIB-4 ve APRI’nin devam ettigi gözlendi. Çalismamizda ortalama takip süresi 27.8 ± 24.3 ay olup, takipte dogrudan etkili antiviral tedavisi sonrasi sadece bir hastaya hepatosellüler kanser tanisi konuldu. Sonuç: FIB-4 ve APRI skorlarindaki erken düsüs, karaciger enzimlerindeki azalma ile iliskili olabilir. Bununla birlikte, takiplerde düsük düzeyde invaziv olmayan skorlarin devam etmesi, nekroinflamasyonda bir azalma ile iliskilendirilmistir.
Abstract
Background and Aims: About 400 000 patients with hepatitis C virus die from cirrhosis-related complications and hepatocellular carcinomaevery year. Direct-acting antivirals provide a sustained virologic response in more than 90% of patients with hepatitis C virus infection. We aimed toevaluate the alteration of the non-invasive fibrosis index in patients with hepatitis C virus who were treated with direct-acting antivirals. Materialsand Method: Patients with hepatitis C virus who received a complete course of direct-acting antivirals were analyzed. FIB-4 and APRI were calculated for each patient. Results: Of the 88 patients, 46 (52%) were males, and 21 (23.8%) were cirrhotics. The mean age was 58 years. The significant decrease was showed in the non-invasive scores compared from the baseline to the end of treatment. There was a statistically significantdrop in mean FIB-4 and APRI scores from baseline to post sustained virologic response (p < 0.001). In the long-term follow-up, it was observedto continue low FIB-4 and APRI at 15 months post sustained virologic response. Mean follow up-time was 27.8 ± 24.3 months in our study, andjust one patient was diagnosed with hepatocellular cancer after direct-acting antivirals treatment during follow-up. Conclusion: An early declinein FIB-4 and APRI scores can be related to a decrease in liver enzymes. Nonetheless, maintaining a low level of non-invasive markers has beenlinked to a reduction in necroinflammation.
