Assessment of the presence of steatosis using Controlled Attenuation Parameter (CAP) and its effect on treatment outcome in Egyptian patients with chronic hepatitis C virus (HCV) treated with sofosbuvir based regimens / Shahira Ahmed Mahmoud Afifi ; Supervised Rasha Ahmed Abdelaziz , Mai Ismail Mehrez , Marwa Khairy Mehasseb

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

therapies for treatment of HCV genotype 4, achieving high SVR12 rates with a good safety profile. Steatosis has been shown to negatively affect the response to the standard of care treatment, increase disease severity and rate of fibrosis progression. Controlled Attenuation Parameter (CAP) is good at detecting steatosis and at differentiating between steatosis grades at {u2265}two grades apart. Aim of work:Evaluation of the steatosis changes in chronic HCV patients along with assessment the effect of steatosis on treatment response. Patients and methods:The study was conducted on 155 patients with chronic HCV and BMI <30; divided into three groups according to treatment regimen. Group 1(n=82) received Sofosbuvir +Daclatasvir ± RBV for 12 weeks, group 2 (n=42) received Sofosbuvir and simeprevir for 12 weeks and group 3 (n=31) received Sofosbuvir, Peg-IFN and RBV for 12 weeks. All patients were subjected to pretreatment and 3 months post treatment laboratory evaluation and assessment of steatosis &liver stiffnesswith TE, CAP. Results:A notable statistical significant difference regarding the effect of treatment by sofosbuvir based regimens on steatosis score (TE, CAP) of both the population (P <0.001) and in each studied group(P < 0.001 of group 1, P=0.006 of group 2 and P=0.002 of group 3) concerning improvement, worsening and stationary steatosis; 56.7% showed stationary steatosis, 21.3% showed improvement, while 22% showed worsened steatosis.Regression of liver stiffness was found in all patients (P=0.001) specially in group 2 (P=0.02) and group 3 (P=0.001).SVR12 rate of sofosbuvir based regimens was 93.6%; the best was in group 2 (97.6%), followed by group 1 (94%) then group 3 (87%)

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