Ongoing liver inflammation in patients with chronic hepatitis C and sustained virological response

• DOI: 10.1371/journal.pone.0171755
• Publication Date: 2017-02-14T19:52:49Z
• Authors: Christoph Welsch; Mira Efinger; Michael von Wagner; Eva Herrmann; Stefan Zeuzem; Tania M. Welzel; Christian M. Lange
• Keywords: Hepatitis C; Inflammatory response

Background Novel direct-acting antiviral DAA combination therapies tremendously improved sustained virologic response (SVR) rates in patients with chronic HCV infection. SVR is typically accompanied by normalization of liver enzymes, however, hepatic inflammation, i.e. persistently elevated aminotransferase levels may persist despite eradication. Aim: To investigate prevalence and risk factors for ongoing inflammation after two large patient cohorts. Methods This post-hoc analysis was based on prospectively collected demographic clinical data from 834 treatment either PegIFN- or DAA-based regimens the PRAMA trial (n = 341) treated at our outpatient clinic 493). Results We observed an unexpected high post-SVR including who received novel IFN-free therapies. Up to 10% had elevation another 25% showed activity above so-called healthy range. Several baseline were independently associated elevation. Among those, particularly male gender, advanced disease markers steatosis strongly predictive persistent ALT The use IFN-based correlated further supporting overall benefit regimens. Conclusion first comprehensive study a cohort investigating eradication HCV. Our show proportion potential implications management approximately one third all upon SVR.