A report in Alimentary Pharmacology and Therapeutics revealed that Liver stiffness and liver fat (steatosis) in chronic hepatitis C virus (HCV) infected patients improved considerably post-treatment with direct-acting antivirals (DAAs) resulting in sustained virological response (SVR). A fall in ALT levels and a rise in platelet count was observed six months after SVR.

It is still ambiguous whether SVR following HCV therapy with DAAs is related to improvements in steatosis.

About half of hepatitis C positive patients suffer from steatosis and it is more rampant in people with hepatitis C genotype 3 infection. Few studies show that in untreated people with hepatitis C genotype 3, steatosis progresses into more aggressive fibrosis. In genotype 1 infection, steatosis will mostly result in metabolic problems such as diabetes.

Although it is observed that liver fibrosis begins to recover after the hepatitis C infection is removed, it is less obvious that steatosis diminishes after DAA treatment.

A prospective study involving 198 people was designed by investigators from Japan with SVR after DAA therapy. The participants were treated between 2015 and 2016. Of the participants, 58% of them were women and the average age was 72 years. All the participants had HCV monoinfection with genotypes 1 or 2.

MRI imaging (proton density fat fraction – PDFF – for steatosis) was used to evaluate liver stiffness and steatosis at baseline and repeated 24 weeks after SVR. Blood values, including ALT and platelet count, were also supervised at the same time intervals.

For comparison, the investigators also evaluated liver stiffness and steatosis values in nine people without SVR after DAA therapy. There were no marked changes in either of the measures between baseline and 24SVR.