Decrease in Apri Score in Compensated Liver Cirrhosis Patients Due to Hepatitis C After a Combination Therapy of Sovosbuvir and Daclatasvir
Abstract
AIM: Hepatitis C is a hepatitis C virus (HCV) infection that targets the liver and can cause fibrosis, cirrhosis, and eventually death. The treatment of hepatitis C has progressed considerably, the combination of sofosbuvir and daclatasvir with 92-100% SVR (Sustained Virologic Response) can increase reversibility of compensated liver cirrhosis after sofosbuvir and daclatasvir therapy.
MATERIALS AND METHODS: This study used observational analytic study design. The subjects were hepatitis C compensated liver cirrhosis patients who received combination therapy sofosbuvir and daclatasvir in the Gastroentero-hepatology clinic of Dr. Hasan Sadikin Hospital Bandung from October 2017 until October 2018. In this study, measurement of liver fibrosis was carried out by using AST to Platelet Ratio Index (APRI) before therapy and SVR-12.
RESULTS: The study involved 23 patients. Most of the subjects were women, with an average age of 59.43 years (SD 11.31). All patients in this study have achieved SVR-24. According to the results, 91% of patients experienced a decrease in APRI scores after being treated with sofosbuvir/daclatasvir. There was a decrease in APRI score before therapy and after SVR 12 from 1.51 to 0.79, the change was 0.878 (95% CI: 0.536 - 1.480). There is a reversal in liver cirrhosis to be non-cirrhosis after being treated with sofosbuvir/daclatasvir which is characterized by a decrease in the APRI score <1 by 80%.
CONCLUSION: The study concluded that the combination of sofosbuvir and daclatasvir in patients with compensated liver cirrhosis with hepatitis C had particularly good effectiveness and could reduce APRI scores
Keywords: APRI score; Compensated liver cirrhosis; Sofosbuvir; DaclatasvirReferences
Gani R. Hepatitis C. Setiati S AI, Sudoyo A, Simadibrata M, Setiyohadi B, Syam A, editor. Jakarta: Internal Medicine Textbook; 2014. 1972-7.
Petruziello A MS, Loquercio G, et al. Global Epidemiology of Hepatitis C virus Infection: un update of distribution and circulation of hepatitis C virus genotypes. World J Gastroenterology. 2016;22:7824-40.
Indonesia PPH. National concensus on Hepatitis C treatment. Indonesia PPH, editor. Jakarta 2017.
Abdel-Aziz AM, Ibrahim MA, El-Sheikh AA, Kamel MY, Zenhom NM, Abdel-Raheim S, et al. Effect of Sofosbuvir Plus Daclatasvir in Hepatitis C Virus Genotype-4 Patients: Promising Effect on Liver Fibrosis. Journal of clinical and experimental hepatology. 2018;8(1):15-22.
Gao M NR, Belema M, Snyder LB, Nguyen VN, et al. Chemical genetics strategy identifies an HCV NS5A inhibitor with a potent clinical effect. nature. 2010;465(7294):96-100.
AASLD/IDSA. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C HCV guidance panel hepatology. 2017;62(3):932-54.
Dolmazashvili E1 AA, Chkhartishvili N, Karchava M, Sharvadze L, Tsertsvadze T. Regression of liver fibrosis over a 24-week period after completing direct-acting antiviral therapy in patients with chronic hepatitis C receiving care within the national hepatitis C elimination program in Georgia: results of hepatology clinic HEPA experience. Eur J Gastroenterol Hepatol. 2017;29(11):1223-1230.
Patch D DA. biopsy of the liver DooleyJ LA, Burrough A, Heathcote, editor. Oxford UK: Wiley-Blackwell Publishing; 2016.
R. Carrara AF, E. Francesch et al. Non-invasive evaluation of change in liver fibrosis after viral eradication in patients with HCV related cirrhosis. 2018;50: 61.
Shiffman ML SR, Contos M, Hubbard S, et al. Long term changes in liver histology following treatment of chronic hepatitis C virus. Ann Hepatol. 2014;13(4):340-9.
Tada T KT, Toyoda H, Mizuno K, Sone Y, Kataoka S, Hashinokuchi S. Improvement of liver stiffness in patients with hepatitis C virus infection who received direct-acting antiviral therapy and achieved sustained virological response. J Gastroenterol Hepatol. 2017;32(12):1982-8.
Trivedi HD, Lin SC, D TYL. Noninvasive Assessment of Fibrosis Regression in Hepatitis C Virus Sustained Virologic Responders. Gastroenterology & hepatology. 2017;13(10):587-95.
Grgurevic I, Bozin T, Madir A. Hepatitis C is now curable, but what happens with cirrhosis and portal hypertension afterwards? Clinical and experimental hepatology. 2017;3(4):181-6.
Afdhal N, Zeuzem S, Kwo P, Chojkier M, Gitlin N, Puoti M, et al. Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Engl J Med. 2014;370(20):1889-98.
Liver EAftSot. EASL Recommendations on Treatment of Hepatitis C 2016. J Hepatol 2017:153-94. Epub 2016 Sep 22.
Garg G, Dixit VK, Shukla SK, Singh SK, Sachan S, Tiwari A, et al. Impact of Direct Acting Antiviral Drugs in Treatment Naive HCV Cirrhosis on Fibrosis and Severity of Liver Disease: A Real Life Experience from a Tertiary Care Center of North India. Journal of clinical and experimental hepatology. 2018;8(3):241-9.
Muir AJ. Understanding the Complexities of Cirrhosis. Clinical therapeutics. 2015;37(8):1822-36.
D'Amico G, Pasta L, Morabito A, D'Amico M, Caltagirone M, Malizia G, et al. Competing risks and prognostic stages of cirrhosis: a 25-year inception cohort study of 494 patients. Alimentary pharmacology & therapeutics. 2014;39(10):1180-93.
Sulkowski MS, Gardiner DF, Rodriguez-Torres M, Reddy KR, Hassanein T, Jacobson I, et al. Daclatasvir plus sofosbuvir for previously treated or untreated chronic HCV infection. N Engl J Med. 2014;370(3):211-21.
Sulkowski MS, Jacobson IM, Nelson DR. Daclatasvir plus sofosbuvir for HCV infection. N Engl J Med. 2014;370(16):1560-1.
Iacob S, Cerban R, Pietrareanu C, Ester C, Iacob R, Gheorghe C, et al. 100% sustained virological response and fibrosis improvement in real-life use of direct acting antivirals in genotype-1b recurrent hepatitis C following liver transplantation. Journal of gastrointestinal and liver diseases : JGLD. 2018;27(2):139-44.
Baden R, Rockstroh JK, Buti M. Natural history and management of hepatitis C: does sex play a role? The Journal of infectious diseases. 2014;209 Suppl 3:S81-5.
Rantala M, van de Laar MJ. Surveillance and epidemiology of hepatitis B and C in Europe - a review. Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. 2008;13(21).
Wiese M, Fischer J, Lobermann M, Gobel U, Grungreiff K, Guthoff W, et al. Evaluation of liver disease progression in the German hepatitis C virus (1b)-contaminated anti-D cohort at 35 years after infection. Hepatology. 2014;59(1):49-57.
Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997;349(9055):825-32.
Villa E, Vukotic R, Camma C, Petta S, Di Leo A, Gitto S, et al. Reproductive status is associated with the severity of fibrosis in women with hepatitis C. PloS one. 2012;7(9):e44624.
Hayashi J, Kishihara Y, Ueno K, Yamaji K, Kawakami Y, Furusyo N, et al. Age-related response to interferon alfa treatment in women vs men with chronic hepatitis C virus infection. Archives of internal medicine. 1998;158(2):177-81.
Gordon SC, Lamerato LE, Rupp LB, Holmberg SD, Moorman AC, Spradling PR, et al. Prevalence of cirrhosis in hepatitis C patients in the Chronic Hepatitis Cohort Study (CHeCS): a retrospective and prospective observational study. The American journal of gastroenterology. 2015;110(8):1169-77; quiz 78.
Deterding K, Honer Zu Siederdissen C, Port K, Solbach P, Sollik L, Kirschner J, et al. Improvement of liver function parameters in advanced HCV-associated liver cirrhosis by IFN-free antiviral therapies. Alimentary pharmacology & therapeutics. 2015;42(7):889-901.
Ji F, Wang W, Dang S, Wang S, Li B, Bai D, et al. Outcomes after sofosbuvir-containing regimens for hepatitis C virus in patients with decompensated cirrhosis: a real-world study. Infectious agents and cancer. 2017;12:48.
Mohamed MS, Hanafy AS, Bassiony MAA, Hussein S. Sofosbuvir and daclatasvir plus ribavirin treatment improve liver function parameters and clinical outcomes in Egyptian chronic hepatitis C patients. Eur J Gastroenterol Hepatol. 2017;29(12):1368-72.
Khan ST, McGuinty M, Corsi DJ, Cooper CL. Liver enzyme normalization predicts success of Hepatitis C oral direct-acting antiviral treatment. Clinical and investigative medicine Medecine clinique et experimentale. 2017;40(2):E73-E80.
Van der Meer AJ, Maan R, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, et al. Improvement of platelets after SVR among patients with chronic HCV infection and advanced hepatic fibrosis. J Gastroenterol Hepatol. 2016;31(6):1168-76.
Dahal S, Upadhyay S, Banjade R, Dhakal P, Khanal N, Bhatt VR. Thrombocytopenia in Patients with Chronic Hepatitis C Virus Infection. Mediterranean journal of hematology and infectious diseases. 2017;9(1):e2017019.
Bachofner JA VP, Kröger, Bergamin I. Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis-4 score and aspartate aminotransferase-platelet ratio index. Liver Int. 2017;37(3):369-76. Epub 2016 Nov 3.
Tao YC, Deng R, Wang ML, Lv DD, Yuan M, Wang YH, et al. Satisfactory virological response and fibrosis improvement of sofosbuvir-based regimens for Chinese patients with hepatitis C virus genotype 3 infection: results of a real-world cohort study. Virology journal. 2018;15(1):150.
Jung YK, Yim HJ. Reversal of liver cirrhosis: current evidence and expectations. The Korean journal of internal medicine. 2017;32(2):213-28.
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