Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome

Abstract Direct-acting antivirals (DAA) have replaced interferon (IFN)-based therapies for hepatitis C virus. In this retrospective clinical study, we examined differences in histopathologic features in paired liver biopsies collected from the same patient before and after DAA and correlated these f...

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Autores principales:	Omar A. Saldarriaga, Bradley Dye, Judy Pham, Timothy G. Wanninger, Daniel Millian, Michael Kueht, Benjamin Freiberg, Netanya Utay, Heather L. Stevenson
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/883254453eb34800b1c9c7047f0e7a8d
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spelling	oai:doaj.org-article:883254453eb34800b1c9c7047f0e7a8d2021-12-02T15:33:13ZComparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome10.1038/s41598-021-93881-72045-2322https://doaj.org/article/883254453eb34800b1c9c7047f0e7a8d2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93881-7https://doaj.org/toc/2045-2322Abstract Direct-acting antivirals (DAA) have replaced interferon (IFN)-based therapies for hepatitis C virus. In this retrospective clinical study, we examined differences in histopathologic features in paired liver biopsies collected from the same patient before and after DAA and correlated these findings with clinical outcome. Biopsies (n = 19) were evaluated by quantitative imaging analysis to measure steatosis and fibrosis. Most patients had decreased steatosis in their post-treatment, follow-up biopsies. However, one patient had a striking increase in steatosis (from 0.86 to 6.32%) and later developed decompensated cirrhosis and hepatocellular carcinoma (HCC). This patient had a marked increase in fibrosis between biopsies, with a CPA of 6.74 to 32.02. Another patient, who already had bridging fibrosis at the time of her pre-treatment biopsy, developed cholangiocarcinoma after DAA. Even though the overall inflammatory activity in the post-treatment biopsies significantly decreased after treatment, 60% of patients had persistent portal lymphocytic inflammation. In summary, DAAs decreased steatosis and hepatic inflammation in most patients, although some may have persistence of lymphocytic portal inflammation. Patients known to have advanced fibrosis at treatment initiation and who have other risk factors for ongoing liver injury, such as steatosis, should be followed closely for the development of adverse outcomes, such as portal hypertension and primary liver cancers.Omar A. SaldarriagaBradley DyeJudy PhamTimothy G. WanningerDaniel MillianMichael KuehtBenjamin FreibergNetanya UtayHeather L. StevensonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Omar A. Saldarriaga Bradley Dye Judy Pham Timothy G. Wanninger Daniel Millian Michael Kueht Benjamin Freiberg Netanya Utay Heather L. Stevenson Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
description	Abstract Direct-acting antivirals (DAA) have replaced interferon (IFN)-based therapies for hepatitis C virus. In this retrospective clinical study, we examined differences in histopathologic features in paired liver biopsies collected from the same patient before and after DAA and correlated these findings with clinical outcome. Biopsies (n = 19) were evaluated by quantitative imaging analysis to measure steatosis and fibrosis. Most patients had decreased steatosis in their post-treatment, follow-up biopsies. However, one patient had a striking increase in steatosis (from 0.86 to 6.32%) and later developed decompensated cirrhosis and hepatocellular carcinoma (HCC). This patient had a marked increase in fibrosis between biopsies, with a CPA of 6.74 to 32.02. Another patient, who already had bridging fibrosis at the time of her pre-treatment biopsy, developed cholangiocarcinoma after DAA. Even though the overall inflammatory activity in the post-treatment biopsies significantly decreased after treatment, 60% of patients had persistent portal lymphocytic inflammation. In summary, DAAs decreased steatosis and hepatic inflammation in most patients, although some may have persistence of lymphocytic portal inflammation. Patients known to have advanced fibrosis at treatment initiation and who have other risk factors for ongoing liver injury, such as steatosis, should be followed closely for the development of adverse outcomes, such as portal hypertension and primary liver cancers.
format	article
author	Omar A. Saldarriaga Bradley Dye Judy Pham Timothy G. Wanninger Daniel Millian Michael Kueht Benjamin Freiberg Netanya Utay Heather L. Stevenson
author_facet	Omar A. Saldarriaga Bradley Dye Judy Pham Timothy G. Wanninger Daniel Millian Michael Kueht Benjamin Freiberg Netanya Utay Heather L. Stevenson
author_sort	Omar A. Saldarriaga
title	Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
title_short	Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
title_full	Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
title_fullStr	Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
title_full_unstemmed	Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
title_sort	comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis c and correlation with clinical outcome
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/883254453eb34800b1c9c7047f0e7a8d
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Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome

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