Long term assessment of hepatic fibrosis after directly acting antiviral therapy for HCV recurrence post liver transplantation by liver stiffness measurement and ARFI / Mohamed Mohamed Bassam Faek Mohamed Hashem ; Supervised Ayman Yosry Abdelrahim , Mohamed Said Abdelaziz , Rasha Mohamed Tawfik Eletreby

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

Background & Aim: Liver fibrosis progression in recurrent HCV infection after liver transplantation (LT) is accelerated. The appearance of new DAAs, has offered treatment of such infection with an all-oral regimen for short duration, excellent safety profile and high SVR rates. Recent reports state that cirrhosis may regress or revert in some cases, after elimination of the causative injury. The aim of our study was to prospectively evaluate the possibility of fibrosis regression in patients with HCV recurrence post LT after DAAs therapy. Methods: Fifty-two patients who were eligible for treatment of HCV post LT were enrolled. They were subjected to demographic, clinical, laboratory assessment and abdominal ultrasound. APRI, FIB-4 and liver stiffness measurement by ARFI and FibroScan® were assessed for all patients. Patients were followed up for 18 months after antiviral therapy. Results: Mean age was 53.61 years, 88.46% were males, average BMI was 28.57 kg/m2 and 25% were cirrhotics as per fibroscan classification. 28 patients (53.84%) had fibrosis score of F2 (group 1) and 24 patients (46.16%) of F3 and F4 (group 2). A significant reduction in values of FIB4 and APRI at end of treatment was noticed in group 1 only (p value of 0.002 and 0.007 respectively). However, on long term assessment; (18 months after treatment), a significant reduction in fibrosis serum biomarkers, transient elastography and ARFI was observed in both groups. In addition, ARFI was more sensitivite and specific than serum biomarkers in the setting of LT

Issued also as CD