Sustained Improvements in Markers of Liver Disease Severity After Hepatitis C Treatment Article

Full Text via DOI: 10.1016/j.jceh.2019.09.001 PMID: 32189926 Web of Science: 000519997300003

Cited authors

  • Wong, Robert J.; Jain, Mamta K.; Therapondos, George; Shiffman, Mitchell L.; Kshirsagar, Onkar; Clark, Christopher; Thamer, Mae


  • Background & aims: Although serological markers of disease severity improve after hepatitis C virus (HCV) treatment, it is unclear if all patients experience sustained improvement. We aim to evaluate longitudinal changes in aspartate (AST), alanine (ALT) aminotransferase, platelet count (PLT), and fibrosis-4 (FIB-4) after HCV treatment. Methods: All adult chronic HCV patients who received antiviral therapy from January 2011 to February 2017 at four large urban hospital systems were evaluated to assess changes in AST, ALT, PLT, and FIB-4 from pre-treatment to post-treatment annually up to 4 years after HCV therapy. Comparisons used Student's t-test and analysis of variance, and were stratified by sex, race, ethnicity, age, body mass index (BMI), and diabetes mellitus. Results: Among 2691 patients (62.2% men, 76.9% aged 45-65 years, 56.5% white), all markers of disease severity demonstrated sustained improvements from pre-treatment to 4 years post-treatment (AST 53 U/L to 27.5 U/L, ALT 53 U/L to 29 U/L, PLT 168 x 10(3) to 176 x 10(3), FIB-4 2.51 to 1.68). However, Hispanics and patients with BMI >30 kg/m(2) experienced rebound increases in AST, ALT, and FIB-4 at 4 years post-treatment after experiencing initial improvements in these serological markers in the first-year post-treatment. Sustained improvements in PLT were observed in all groups, including Hispanics and patients with BMI >30 kg/m(2). Conclusion: HCV treatment in a large community-based cohort demonstrated sustained improvements in AST, ALT, PLT, and FIB-4. Rebound increases in AST, ALT, and FIB-4 observed in Hispanics and those with BMI >30 kg/m(2) may reflect persisting nonalcoholic fatty liver disease.

Publication date

  • 2020


International Standard Serial Number (ISSN)

  • 0973-6883

Start page

  • 114

End page

  • 123


  • 10


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