Araştırma Çıktıları

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Subject: search.filters.subject.direct-acting antivirals

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    Long-term Kinetics of Alpha-fetoprotein in Chronic Hepatitis C Patients Treated with Direct-acting Antivirals and Possible Predictive Role of AFP Response to Treatment on Development of Hepatocellular Carcinoma
    (GALENOS YAYINCILIK, 2021-01-01) Ulasoglu, Celal; Senates, Banu Erkalma; Yapali, Suna; Dumanoglu, Betul; Enc, Feruze; Colak, Yasar; Senates, Ebubekir
    Objectives: To evaluate the post-treatment upto fourth-year kinetics of alpha-fetoprotein (AFP) in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral (DAA) drugs. Materials and Methods: In this retrospective, single-center study, 182 patients (124 female, 58 male) with CHC treated with DAA were included in the study. Biochemistry and AFP were recruited from the hospital database. The data at pre-treatment, 3rd and 48th month after the end of treatment were evaluated. Results: Of the 182 patients, mean age was 58 +/- 12 (28-76), and forty-nine (27\%) had cirrhosis. At month 3, the average decline of AFP was 35.6\% (0.4-97.0). Early decline of AFP <8.7\% was found to be a predictor for HCC development. Mean AFP was 7.7 +/- 9.2 ng/mL at pre-treatment and 3.8 +/- 2.7 at third month (p<0.001). The decline persisted at 48th month (3.6 +/- 2.4 ng/mL). Conclusion: Early decline of AFP and persistence at fourth-year after DAA treatment was observed, except five cases developing HCC. Inadequate decline in AFP level found to be a possible predictor for HCC development. However, these results needs to be confirmed in large-scale multicenter cohorts. This study highlights the importance of AFP response to DAA treatment in identifying HCC risk, especially in patients with cirrhosis.
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    An Evaluation of Chronic Hepatitis C Patients' Responses to Direct-Acting Antivirals According to Transient Elastography and Serum Biomarkers
    (GALENOS YAYINCILIK, 2022-01-01) Aydin, Nurten Nur; Koksal, Iftihar
    Objectives: In this study, it was evaluated the changes in liver stiffness measurements measured by AST to Platelet Ratio index (APRI), Fibrosis 4 index (FIB-4), Age Platelet index (API), AST-ALT ratio (AAR) and transient elastography (TE) among the non-invasive fibrosis scores in chronic hepatitis C (CHC) patients treated with direct-acting agents (DM) and the effect of treatment. Materials and Methods: Ombitasvir-paritaprevir-ritonavir-dasabuvir +/- ribavirin (RBV) or sofosbuvir +/- ledipasvir (SOF +/- LDV) +/- RBV was given to the patients. Fibrosis scores were calculated with the biochemical data of the patients before the treatment, at the 4s . week of the treatment, at the end of treatment and at the sustained virological response 12 (SVR12) Liver stiffness measurements were recorded before treatment with TE and in SVR12. Post-treatment SVR12 responses were evaluated. Results: SVR12 was achieved in 97.9\% of 95 patients included in the study. Significant regression was found in APRI and FIB-4 scores, which are among the 4 serum fibrosis markers calculated in all patients (p<0.001, p<0.001). Liver stiffness was measured using TE in 75 patients. It was determined that the liver stiffness measurement (9.3 +/- 6.5 kPa) in SVR12 significantly decreased compared to the baseline (11.6 +/- 7.8 kPa) (p<0.001). Conclusion: DAA provides improvement in fibrosis scores and persistent viral response in patients. In our study, in which fibrosis was evaluated non-invasive methods, it was observed that there was a significant improvement in liver fibrosis with APRI, FIB-4 and TE measurements.