Avaliação do impacto dos biomarcadores diretos de fibrose hepática antes e após o tratamento da hepatite C

Abstract

Infection with the Hepatitis C virus (HCV) is one of several etiologies of liver damage. It is estimated that 71 million people worldwide have chronic infection with the virus. A significant number of these chronic infected people will develop cirrhosis and some will develop hepato-cellular carcinoma (HCC). Currently, for the assessment of hepatic fibrosis, the following are used: the APRI and FIB4 indices; liver elastography, recommended before treatment; and biopsy, which despite presenting some disadvantages and complications for the patient, remains the gold standard method. For this reason, studies have emerged on the ability of direct markers to assist in the assessment of post-treatment liver fibrosis, as these are components directly involved in the balance of the extracellular matrix and associated with collagen degradation and deposition. In this context, our objective was to evaluate eight direct serological markers in patients infected with HCV before and after treatment, comparing them with the degree of fibrosis classified by the APRI and FIB4 methods and associating them with the data related with viral characteristics. For this, data were collected from medical records and biological samples from 24 patients, before and after treatment with DAAs. The results showed that there was a decrease in the APRI and FIB4 values, indicating an improvement in fibrosis after treatment, while there was a significant increase in COLIV, TIMP1 and 2 and a significant decrease in MMP1 and 2, suggesting a worsening in the degree of fibrosis after treatment. We conclude, therefore, that after treatment with DAAs, patients should be monitored to assess a possible negative impact of their use on the immune system and a temporary depressive process resulting from the abrupt elimination of the virus from the body. Further studies should be carried out, with a larger number of patients, inclusion of risk factors associated with liver problems and long-term follow-up to verify these parameters after a longer period of SVR. Anyway, the results of this study represented an advance for offering different pre and post-treatment data related to direct biomarkers