An observational, retrospective study examined the risk factors for liver-related events (LREs) after achieving sustained virological response (SVR) with direct-acting antivirals (DAAs) in patients with advanced chronic liver disease (ACLD) caused by hepatitis C virus (HCV). The study included 321 patients who achieved SVR between 2014 and 2017 and were followed up until December 2020. LREs, including portal hypertension decompensation and hepatocellular carcinoma (HCC), occurred in 13.7% of patients. Key risk factors for portal hypertension decompensation were higher Child-Pugh scores, baseline FIB-4, and FIB-4 scores one and two years post-SVR. For HCC development, older age, genotype 3, diabetes mellitus, and FIB-4 scores before and after SVR were significant predictors.

The study found specific FIB-4 cut-off values to predict portal hypertension decompensation and HCC one and two years post-SVR. Patients with higher FIB-4 scores remained at risk of developing liver complications even after achieving SVR. These findings suggest that FIB-4 evaluation before and after SVR can help predict the risk of LREs. This aids in the selection of patients who would benefit from ongoing surveillance and monitoring to manage potential liver complications effectively.

Reference: Fernández-Alvarez P, Guerra-Veloz MF, Vilches-Arenas A, et al. Dynamic Changes in Non-Invasive Markers of Liver Fibrosis Are Predictors of Liver Events after SVR in HCV Patients. Viruses. 2023 May 26;15(6):1251. doi: 10.3390/v15061251. PMID: 37376551; PMCID: PMC10302896.