2026 Volume 64 Issue 3 Pages 502-511
Background: Long-term changes in liver fibrosis following sustained virological response (SVR) to direct-acting antiviral (DAA) therapy for hepatitis C were analyzed using MR elastography (MRE) and proton density fat fraction (PDFF).
Subjects and Methods: A total of 53 patients infected with hepatitis C virus (HCV) who achieved SVR after DAA therapy were analyzed. Changes in liver stiffness and hepatic steatosis were assessed using MRE and PDFF, respectively. A retrospective analysis was performed to determine the pre-DAA treatment factors associated with improvement in hepatic fibrosis.
Results: Liver stiffness decreased significantly over time after SVR. However, by the third year after SVR, only about half of the patients (14 patients (54%)) had a 19% or greater reduction in liver stiffness compared to their pretreatment levels. A pretreatment factor associated with the non-improvement of liver stiffness was hypertriglyceridemia (p=0.029). Liver steatosis was significantly reduced after 1 year of SVR, but after 2 years there was no significant change from pretreatment levels.
Conclusions: Liver fibrosis gradually improves after SVR, but the degree of improvement is limited in patients with dyslipidemia. In addition to HCV therapy, it is important to manage lifestyle-related diseases, such as dyslipidemia.
