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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background/Objectives: Direct-acting antiviral (DAA) therapy has been highly successful in treating chronic hepatitis C (CHC). The nationwide Treatment as Prevention of Hepatitis C (TraP HepC) initiative that was launched in Iceland in 2016 utilized liver stiffness measurements (LSM) to assess liver fibrosis at baseline and follow-up. We aimed to determine changes in liver stiffness among patients following treatment with DAAs and evaluate risk factors associated with hepatic fibrosis. Methods: Eligible CHC patients with liver stiffness of >9.5 kilopascals (kPa) before DAA treatment were invited for a follow-up visit in 2024. Risk factors for cirrhosis were registered, LSM performed, and liver enzymes, blood lipids, and glucose levels measured. Changes in liver stiffness were compared to baseline measurements, and correlations with risk factors were analyzed. Results: A total of 96 patients had LSMs > 9.5 kPa at treatment initiation. During the follow-up period, 61 were eligible for participation, 38 consented, and 34 (35%) died. The total follow-up was 258.3 person-years. The median follow-up period between measurements was 7.1 years. The median liver stiffness decreased from 17.2 kPa to 7.3 kPa (p < 0.01), and 80% of those with cirrhosis (>12.5 kPa) regressed to non-cirrhotic values. High BMI and daily alcohol consumption were significantly associated with increased liver stiffness in 8% of patients. Conclusions: In this single-arm, pre-post pilot study, liver stiffness regressed significantly in 92% of patients who were cured of CHC. Patients with other persistent risk factors following cure, such as obesity and alcohol abuse, were the only patients who had increased liver stiffness at the end of follow-up.

Details

Title
Clinically Important Decrease in Liver Stiffness Following Treatment for Hepatitis C: Outcome of the TraP HepC Nationwide Elimination Program
Author
Freyr, Kristjánsson Smári 1 ; Olafsson Sigurdur 2 ; Gottfredsson Magnús 3   VIAFID ORCID Logo  ; Love, Thorvardur Jon 4 ; Björnsson, Einar Stefán 5   VIAFID ORCID Logo 

 Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland; [email protected] (S.F.K.); [email protected] (M.G.); [email protected] (T.J.L.) 
 Division of Gastroenterology and Hepatology, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland; [email protected] 
 Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland; [email protected] (S.F.K.); [email protected] (M.G.); [email protected] (T.J.L.), Department of Infectious Diseases, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland, Department of Science, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland 
 Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland; [email protected] (S.F.K.); [email protected] (M.G.); [email protected] (T.J.L.), Department of Science, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland 
 Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland; [email protected] (S.F.K.); [email protected] (M.G.); [email protected] (T.J.L.), Division of Gastroenterology and Hepatology, Landspitali—The National University Hospital of Iceland, 101 Reykjavik, Iceland; [email protected] 
First page
3982
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
20770383
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3217736226
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.