Thomas Damgaard Sandahl

Time-dependent improvement of liver inflammation, fibrosis and metabolic liver function after successful direct-acting antiviral therapy of chronic hepatitis C

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

Sofosbuvir-based direct-acting antiviral (DAA) therapy generally cures chronic hepatitis C (CHC) infections, and however, the effects on the underlying liver disease and the potential rate of recovery are unclear. We aimed to investigate the effects of DAA therapy on liver inflammation, fibrosis, metabolic function and cognitive function and the time course in CHC patients with advanced liver disease. Seventy-one CHC patients with advanced liver disease were studied before, during and one year after successful sofosbuvir-based DAA therapy. Liver inflammation was assessed by plasma sCD163 and sMR levels (ELISA), fibrosis by liver stiffness (transient elastography), function by galactose elimination capacity (GEC) and cognitive performance by continuous reaction time (CRT). During DAA therapy, we observed a rapid sCD163 decline from baseline to end of treatment (6.9 vs 3.8 mg/L, P <.0001), whereas the change in sMR was more subtle (0.37 vs 0.30 mg/L, P <.0001). Liver stiffness decreased by 20% at end of treatment (17.8 vs 14.3 kPa, P <.0001), together suggesting rapid resolution of liver inflammation. One year after treatment, liver stiffness decreased by an additional 15% (P <.0001), suggestive of fibrosis regression. The GEC improved at follow-up (all: 1.74 vs 1.98 mmol/min), mainly at 12 weeks post-treatment, both in patients with cirrhosis (n = 56) and those with advanced liver fibrosis (n = 15) (P <.001). The CRT improved at one-year follow-up (1.86 vs 2.09, P =.04). In conclusion, successful DAA therapy of CHC proves beneficial in advanced liver disease, with an initial rapid resolution of liver inflammation and a subsequent gradual but steady improvement in liver fibrosis, metabolic liver function and reaction time.

Original languageEnglish
JournalJournal of Viral Hepatitis
Number of pages8
ISSN1352-0504
DOIs
Publication statusE-pub ahead of print - 2019

    Research areas

  • chronic hepatitis C, direct-acting antiviral therapy, fibrosis, metabolic liver function, portal hypertension, VIRUS, FOLLOW-UP, NATURAL-HISTORY, SUSTAINED VIROLOGICAL RESPONSE, TRANSIENT ELASTOGRAPHY, MACROPHAGE ACTIVATION MARKER, CIRRHOSIS, GALACTOSE ELIMINATION CAPACITY, INFECTION, NONINVASIVE ASSESSMENT

See relations at Aarhus University Citationformats

ID: 170331709