2020 Volume 69 Issue 1 Pages 75-81
Liver biopsy is considered the “gold standard” for the evaluation of hepatic fibrosis. On the other hand, we widely use serum fibrosis markers in routine practice because measuring them is less invasive. In recent years, the efficiency of hepatitis C therapy has considerably improved owing to the development of DAA therapy, but the effect of DAA therapy on the levels of fibrosis markers is unclear. In this study, we compared the levels of fibrosis markers before and after therapy in 54 patients with chronic hepatitis C, who were treated with DAAs in our hospital. Furthermore, we compared these levels by classifying patients into those with advanced and those with nonadvanced liver fibrosis on the basis of the results of liver biopsy to examine the difference in the changes depending on the stage of liver fibrosis. Results showed that there were significant changes in platelet counts and the levels of the Mac-2 binding protein glycosylation isomer and type IV collagen 7S in serum after DAA therapy, regardless of the severity of liver fibrosis. On the other hand, although there was no significant difference in the level of type IV collagen in the preclassification comparison, the postclassification comparison showed a significant increase in the type IV collagen level in the patients with nonadvanced liver fibrosis but not in those with advanced liver fibrosis. It was considered that this is due to changes in the expression levels of type IV collagenolytic enzymes depending on the severity of liver fibrosis and inflammation improvement. It is necessary to be careful in the interpretation of the levels of fibrosis markers after DAA therapy because each marker shows different changes. Liver fibrosis assessment based on the levels of fibrosis markers should be carried out comprehensively considering the dynamics among these parameters.
