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

Chen Hua Liu, Yu Ping Chang, Yu Jen Fang, Pin Nan Cheng, Chi Yi Chen, Wei Yu Kao, Chih Lin Lin, Sheng Shun Yang, Yu Lueng Shih, Cheng Yuan Peng, Ming Chang Tsai, Shang Chin Huang, Tung Hung Su, Tai Chung Tseng, Chun Jen Liu, Pei Jer Chen, Jia Horng Kao

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Information on the dynamics of metabolic dysfunction-associated steatotic liver disease (MASLD) among hepatitis C virus patients achieving sustained virologic response (SVR12) with direct-acting antivirals (DAAs) is limited. Methods: 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 SVR12. Forward stepwise logistic regression analyses were performed to determine factors significantly associated with the regression or emergence of MASLD. Results: The prevalence of MASLD decreased from 45.0% before treatment to 36.1% at SVR12. Among 681 participants with MASLD before treatment, 144 (21%) exhibited MASLD regression at SVR12. Conversely, among 831 participants without MASLD before treatment, 9 (1.1%) developed MASLD at SVR12. 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). Conclusions: The prevalence of MASLD decreased after achieving SVR12 with DAAs. Patients with pre-existing T2D showed a diminished probability of MASLD regression and a heightened risk of MASLD emergence post-SVR12.

Original languageEnglish
JournalJournal of Gastroenterology
DOIs
Publication statusPublished - Apr 13 2024

Keywords

  • Controlled attenuation parameter
  • Direct-acting antiviral
  • Hepatitis C virus
  • Metabolic dysfunction-associated steatotic liver disease
  • Sustained virologic response

ASJC Scopus subject areas

  • Gastroenterology

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