Evoluția fibrozei hepatice la pacienții cu ciroză hepatică virală c după tratamentul cu preparate antivirale cu acțiune directă

Irina Russu; Mariana Avricenco; Ina Bîstrițchi; Nina Tamojnic-Mazureac; Adelina Butnaru; Tiberiu Holban

The evolution of liver fibrosis in patients with viral hepatitis C after treatment with direct-acting antiviral drugs

Authors

Irina Russu Nicolae Testemițanu State University of Medicine and Pharmacy https://orcid.org/0000-0002-2759-3171
Mariana Avricenco Republican Clinical Hospital for Infectious Diseases "Toma Ciorba" https://orcid.org/0009-0006-7014-3834
Ina Bistritchi Nicolae Testemițanu State University of Medicine and Pharmacy https://orcid.org/0000-0003-3626-5281
Nina Tamojnic-Mazureac Nicolae Testemițanu State University of Medicine and Pharmacy https://orcid.org/0009-0006-7331-1944
Adelina Butnaru Republican Clinical Hospital for Infectious Diseases "Toma Ciorba"
Tiberiu Holban Nicolae Testemițanu State University of Medicine and Pharmacy https://orcid.org/0000-0003-0923-3129

Keywords:

APRI, Fib-4, cirrhosis, HCV, antiviral treatment

Abstract

Treatment with direct-acting antiviral drugs (DAAs) offers a chance of cure for most patients with VHC, regression of liver fibrosis, and to prevent the progression to liver cirrhosis, which can lead to decompensated cirrhosis and hepatocellular carcinoma. Noninvasive methods of fibrosis assessment, such as the APRI index and Fib-4 score, offer the possibility of monitoring the progression of liver fibrosis. The study included 310 patients with liver cirrhosis, divided into two groups according to the duration and regimen of treatment. Of the 310 patients with VHC cirrhosis treated with DAAs, 290 (93.5%) achieved SVR12. At the start of treatment, the average fibrosis was 28.0±11.5 kPa, of which 201 (64.8%) patients had advanced liver cirrhosis with a median >20 kPa, APRI index >2 - in 167 (53.9%) of them. One year after RVS12, a reduction in the median fibrosis of 4.2 kPa was observed using elastography, and four years after RVS12, a reduction of 14 kPa was observed (P < 0.0001). The FIB-4 score >3.25 in 215 (69.4%) at the beginning of treatment was maintained in 91 (29.4%) patients, the APRI index >2 being in 167 (53.9%), remained between 1-2 in 10 (3.2%), and no patient had an APRI >2 (P < 0.0001). Cure of HCV infection is associated with regression of liver fibrosis after PAAD treatment, as evidenced by decreased APRI, FIB-4, and elastography scores, regardless of treatment regimen and duration.

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2025-12-01

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No. 2(104) (2025): Supliment. Al VI-lea Congres Național de Gastroenterologie și Hepatologie din Republica Moldova cu participare internațională

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Russu, I. et al. 2025. The evolution of liver fibrosis in patients with viral hepatitis C after treatment with direct-acting antiviral drugs. Public Health, Economy and Management in Medicine. 2(104) (Dec. 2025), 141–146.

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The evolution of liver fibrosis in patients with viral hepatitis C after treatment with direct-acting antiviral drugs

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