Dynamic change of metabolic dysfunction-associated steatotic liver disease in patients with hepatitis C virus infection after achieving sustained virologic response with direct-acting antivirals.
Journal
Journal of gastroenterology
Journal Volume
59
Journal Issue
7
Pages
609 - 620
ISSN
1435-5922
Date Issued
2024-07
Author(s)
Chang, Yu-Ping
Fang, Yu-Jen
Cheng, Pin-Nan
Chen, Chi-Yi
Kao, Wei-Yu
Lin, Chih-Lin
Yang, Sheng-Shun
Shih, Yu-Lueng
Peng, Cheng-Yuan
Tsai, Ming-Chang
Abstract
Information on the dynamics of metabolic dysfunction-associated steatotic liver disease (MASLD) among hepatitis C virus patients achieving sustained virologic response (SVR) with direct-acting antivirals (DAAs) is limited.
We enrolled 1512 eligible participants in this prospective study. MASLD was defined by a controlled attenuation parameter (CAP) of ≥248 dB/m utilizing vibration-controlled transient elastography in conjunction with presence of ≥1 cardiometabolic risk factor. The distribution of MASLD and the changes in CAP were evaluated before treatment and at SVR. Forward stepwise logistic regression analyses were performed to determine factors significantly associated with the regression or emergence of MASLD.
The prevalence of MASLD decreased from 45.0% before treatment to 36.1% at SVR. Among 681 participants with MASLD before treatment, 144 (21%) exhibited MASLD regression at SVR. Conversely, among 831 participants without MASLD before treatment, 9 (1.1%) developed MASLD at SVR. Absence of type 2 diabetes (T2D) [odds ratio (OR): 1.73, 95% confidence interval (CI): 1.13-2.65, p = 0.011], age > 50 years (OR: 1.73, 95% CI: 1.11-2.68, p = 0.015), and alanine transaminase (ALT) ≤ 2 times the upper limit of normal (ULN) (OR: 1.56; 95% CI: 1.03-2.37, p = 0.035) were associated with the regression of MASLD. Presence of T2D was associated with the emergence of MASLD (OR: 5.83, 95% CI: 1.51-22.56, p = 0.011).
The prevalence of MASLD decreased after achieving SVR with DAAs. Patients with pre-existing T2D showed a diminished probability of MASLD regression and a heightened risk of MASLD emergence post-SVR.
Subjects
Controlled attenuation parameter
Direct-acting antiviral
Hepatitis C virus
Metabolic dysfunction-associated steatotic liver disease
Sustained virologic response
SDGs
Type
journal article