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Fatty liver in hepatitis C patients post-sustained virological response with direct-acting antivirals.

Fatty liver in hepatitis C patients post-sustained virological response with direct-acting antivirals.
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Noureddin M, Wong MM, Todo T, Lu SC, Sanyal AJ, Mena EA,


Noureddin M, Wong MM, Todo T, Lu SC, Sanyal AJ, Mena EA, (click to view)

Noureddin M, Wong MM, Todo T, Lu SC, Sanyal AJ, Mena EA,

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World journal of gastroenterology 24(11) 1269-1277 doi 10.3748/wjg.v24.i11.1269
Abstract
AIM
To determine steatosis and fibrosis prevalence in hepatitis C patients after a sustained virological response achieved with direct-acting antivirals.

METHODS
Transient elastography with controlled attenuation parameter (CAP) was used to assess hepatic steatosis post-sustained virological response (SVR); the CAP technology was not available in the United States at study initiation. Liver stiffness/fibrosis was measured before and 47 wk after treatment completion. Patients with genotype 3 and patients with cirrhosis were excluded.

RESULTS
One hundred and one patients were included in the study. Post-SVR there were decreases from baseline in alanine aminotransferase (ALT) (63.1 to 17.8 U/L), aspartate aminotransferase (51.8 to 21.5 U/L) and fibrosis score (7.4 to 6.1 kPa) (< 0.05). Post-SVR, 48 patients (47.5%) had steatosis on CAP; of these, 6.25% had advanced fibrosis. Patients with steatosis had higher body mass index (29.026.1 kg/m), glucose (107.896.6 mg/dL), ALT (20.415.3 mg/dL), CAP score (296.3212.4 dB/m) and fibrosis score (7.05.3 kPa);< 0.05. Interestingly, compared to baseline, both patients with and without steatosis had change in fibrosis score post-SVR (7.7 kPa7.0 kPa and 7.0 kPa5.3 kPa); alternatively, (< 0.05) and therefore patients with steatosis continued to have clinically significant stiffness (≥ 7 kPa). CONCLUSION
Fatty liver is very common in hepatitis C virus (HCV) patients post-SVR. These patients continue to have elevated mean fibrosis score (≥ 7 kPa) compared to those without fatty liver; some have advanced fibrosis. Long term follow up is needed to assess steatosis and fibrosis in HCV patients post-SVR.

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