Hepatitis C virus (HCV) infection can lead to serious liver-related events (LRE) such as hepatocellular carcinoma (HCC), liver decompensation, and liver-related death. Achieving sustained viral response (SVR) through HCV eradication can halt or reverse liver damage, reducing LRE occurrence. Direct antiviral agents (DAA) enable over 90% of patients to reach SVR. However, post-SVR, remaining liver fibrosis is a key predictor for LRE development, with limited data on fibrosis improvement post-DAA treatment, especially in those with advanced fibrosis or cirrhosis.

This study evaluated long-term changes in liver stiffness (LS) using transient elastography (TE) after achieving SVR through DAA treatment, compared to a historical peg-IFN/RBV cohort. Results showed significant fibrosis regression up to 144 weeks post-DAA treatment, with higher regression rates in the DAA group. Approximately 47.7% and 63.4% of patients showed significant regression at 48 and 96 weeks, respectively. Both groups had similar HCC occurrence rates post-SVR, indicating that DAA treatment effectively reduces fibrosis while maintaining comparable HCC risks to peg-IFN/RBV treatment.

Reference: Yoo HW, Park JY, Kim SG, et al. Regression of liver fibrosis and hepatocellular carcinoma development after HCV eradication with oral antiviral agents. Sci Rep. 2022 Jan 7;12(1):193. doi: 10.1038/s41598-021-03272-1. PMID: 34996920; PMCID: PMC8742091.