Introduction: The goal of treatment of chronic hepatitis C (HCV) is viral eradication. However,
obtaining histological regression is even more important, because it will reduce the overall morbidity
and mortality related to cirrhosis. Introduction of direct-acting antivirals (DAAs) in HCV improves
rates of sustained virologic response (SVR). However, fibrosis regression has not been extensively
assessed. The aim of this study was to detect the factors affecting fibrosis regression in chronic
HCV patients treated with interferon containing regimens versus interferon-free DAA regimens.
Methods: This prospective observational cohort study was conducted at the Tropical Medicine and
Infectious Diseases Department, Tanta University, Egypt, between October 2015 and December 2017.
Transient elastography (FibroScan®) examination was performed before therapy, at SVR12, 6 months
and 1 year after completing therapy for cured patients.
Results: Reduction in fibrosis was reported in; 46.7% and 49.3% of patients with moderate fibrosis,
and 89% and 78.7% of patients with advanced fibrosis after one year of interferon containing and interferon
free DAAs regimens respectively. Using multiple regression analysis; it was found that BMI,
degrees of hepatic stiffness and steatosis were related to regression of hepatic fibrosis after therapy.
Conclusion: DAAs with or without interferon resulted in a significant reduction of liver fibrosis. BMI,
steatosis and liver stiffness were independent factors for fibrosis regression in chronic HCV patients
treated with DAAs. Further studies are needed to explore the mechanism by which steatosis affects
HCV related fibrosis regression after treatment with DAAs.