Real-World Evaluation of APRI and FIB-4 Scores in Patients with Chronic Hepatitis C Treated with Direct-Acting Antivirals Kronik Hepatit C Hastalarında Doğrudan Etkili Antiviral Tedavi Sonrası APRI ve FIB-4 Skorlarının Gerçek Yaşam Verileriyle Değerlendirilmesi
Viral Hepatitis Journal, cilt.32, sa.1, ss.14-18, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.4274/vhd.galenos.2026.2026-2-1
- Dergi Adı: Viral Hepatitis Journal
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.14-18
- Anahtar Kelimeler: Chronic hepatitis C, direct-acting antivirals, APRI, FIB-4, real-world data
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: This study aimed to evaluate biochemical response, sustained virological response (SVR) rates, and changes in non-invasive fibrosis markers [aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis-4 index (FIB-4)] using real-world data in patients with chronic hepatitis C virus (HCV) treated with direct-acting antivirals (DAAs). Materials and Methods: Patients aged ≥18 years with chronic HCV who were followed between January 2018 and December 2024 and treated with glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir, or ledipasvir/sofosbuvir were retrospectively analyzed. Alanine aminotransferase (ALT), AST, platelet count, and HCV-RNA levels were recorded at baseline, at treatment week 4, at end of treatment, and at 12 and 24 weeks after treatment completion. APRI and FIB-4 scores were calculated at each time point. Results: A total of 43 patients were included; the median age was 57 years (interquartile range: 43-65), and 58% were male. ALT and AST levels decreased significantly from treatment week 4 onward (p<0.001). APRI scores showed a significant early decline that persisted throughout the follow-up period (p<0.001). FIB-4 scores decreased significantly at week 4; however, this reduction was not sustained during follow-up. A strong correlation was observed between changes in APRI and ALT, whereas the association between FIB-4 and ALT was weak and limited. SVR12 and SVR24 rates were 100% among patients with available HCV-RNA data. Conclusion: In real-world settings, DAA therapy achieves high SVR rates and rapid biochemical improvement. The early and persistent decline in APRI reflects regression of inflammatory activity, while the limited change in FIB-4 suggests that longer follow-up may be required to adequately assess fibrosis regression.