Non-invasive methods for the diagnosis of liver fibrosis in chronic HCV-infection
https://doi.org/10.22625/2072-6732-2021-13-1-58-65
Abstract
Objective: to study the values of fibrosis indices and transient elastometry in patients with chronic HCV infection who received antiviral therapy.
Materials and methods: The study included 64 patients with chronic HCV infection who received antiviral therapy with direct-acting antiviral drugs or a combination of peginterferon and ribavirin.
The fibrosis indices AAR, APRI and FIB-4 were calculated before the start of therapy and 6 months after its completion. Values of AAR>1, APRI≥1,5, and FIB-4≥1,45 were considered indicators of severe fibrosis. We studied the dynamics of fibrosis indices and elastometry values depending on the treatment regimen, their correlation and the prognostic significance of fibrosis indices in relation to elastometry.
Results. Among patients treated with direct-acting antiviral drugs, a sustained virologic response was achieved in 100%, and peginterferon-containing regimen – in 85%. Elastometry and APRI and FIB-4 indices decreased in both groups. In patients without liver cirrhosis, the average elastometry after treatment decreased from 9,5±1,7 kPa to 6,7 ± 1.4 kPa (p = 0,0006). In patients with liver cirrhosis, the median of elastometry decreased from 20 to 11,7 kPa (p = 0,0006), the median of APRI decreased from 2,09 to 0,61 (p = 0,005), FIB-4 from 3,95 up to 2,22 (p = 0,022). The prognostic significance of FIB-4 in relation to elastometry before treatment was 81%, after – 82%.
Conclusion. Successful etiotropic therapy leads to an improvement in values of liver fibrosis indices and transient elastometry in patients with HCV infection, including liver cirrhosis, regardless of the treatment regimen. The FIB-4 index showed the highest sensitivity and prognostic significance in determining severe fibrosis.
About the Authors
A. I. Fazul’zyanova
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
A. K. Husainova
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
S. V. Tkacheva
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
F. M. Yakupova
Kazan State Medical University
Russian Federation
Russian Federation
Kazan
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Review
For citations:
Fazul’zyanova A.I., Husainova A.K., Tkacheva S.V., Yakupova F.M. Non-invasive methods for the diagnosis of liver fibrosis in chronic HCV-infection. Journal Infectology. 2021;13(1):58-65. (In Russ.) https://doi.org/10.22625/2072-6732-2021-13-1-58-65
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