The changing non-invasive fibrosis index value in patients with hepatitis C treated with direct-acting antiviral agents

Background and Aims: About 400 000 patients with hepatitis C virus die from cirrhosis-related complications and hepatocellular carcinoma every year. Direct-acting antivirals provide a sustained virologic response in more than 90% of patients with hepatitis C virus infection. We aimed to evaluate the alteration of the non-invasive fibrosis index in patients with hepatitis C virus who were treated with direct-acting antivirals. Materials and 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 significant drop 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 observed to 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, and just one patient was diagnosed with hepatocellular cancer after direct-acting antivirals treatment during follow-up. Conclusion: An early decline in FIB-4 and APRI scores can be related to a decrease in liver enzymes. Nonetheless, maintaining a low level of non-invasive markers has been linked to a reduction in necroinflammation.