TY - JOUR
T1 - Comparison of liver biopsies before and after direct-acting antiviral therapy for hepatitis C and correlation with clinical outcome
AU - Saldarriaga, Omar A.
AU - Dye, Bradley
AU - Pham, Judy
AU - Wanninger, Timothy G.
AU - Millian, Daniel
AU - Kueht, Michael
AU - Freiberg, Benjamin
AU - Utay, Netanya
AU - Stevenson, Heather L.
N1 - Funding Information:
We would like to thank Grady Carlson and Akoya Biosciences for their support and guidance in using the Vectra Platform. We extend sincere gratitude to Jeffrey East, physician assistant, and Shana White, study coordinator, for their assistance in acquiring and organizing the clinical samples. Sam Diaz de Leon and Blanca Hernandez provided secretarial support and assistance with obtaining the archived liver biopsy tissue blocks. Min Zhang, licensed histology technician, assisted with cutting the liver biopsy tissue blocks and troubleshooting. Dr. Cornelius Elferink provided a critical review of the manuscript. This work was supported in part by the National Center for Advancing Translational Services Clinical and Translational Science Awards Grant NCATS CTSA Grant KL2 Scholars Program (KL2TR001441-06); Moody Endowment Award, Galveston, TX (2014-07 and LIME 19016); MD Anderson Cancer Center SPORE in Hepatocellular Carcinoma Grant (P50 CA217674); and the National Institute of Diabetes and Digestive and Kidney Diseases (1RO1DK125730-01A1). These funding sources were not involved in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Direct-acting antivirals (DAA) have replaced interferon (IFN)-based therapies for hepatitis C virus. In this retrospective clinical study, we examined differences in histopathologic features in paired liver biopsies collected from the same patient before and after DAA and correlated these findings with clinical outcome. Biopsies (n = 19) were evaluated by quantitative imaging analysis to measure steatosis and fibrosis. Most patients had decreased steatosis in their post-treatment, follow-up biopsies. However, one patient had a striking increase in steatosis (from 0.86 to 6.32%) and later developed decompensated cirrhosis and hepatocellular carcinoma (HCC). This patient had a marked increase in fibrosis between biopsies, with a CPA of 6.74 to 32.02. Another patient, who already had bridging fibrosis at the time of her pre-treatment biopsy, developed cholangiocarcinoma after DAA. Even though the overall inflammatory activity in the post-treatment biopsies significantly decreased after treatment, 60% of patients had persistent portal lymphocytic inflammation. In summary, DAAs decreased steatosis and hepatic inflammation in most patients, although some may have persistence of lymphocytic portal inflammation. Patients known to have advanced fibrosis at treatment initiation and who have other risk factors for ongoing liver injury, such as steatosis, should be followed closely for the development of adverse outcomes, such as portal hypertension and primary liver cancers.
AB - Direct-acting antivirals (DAA) have replaced interferon (IFN)-based therapies for hepatitis C virus. In this retrospective clinical study, we examined differences in histopathologic features in paired liver biopsies collected from the same patient before and after DAA and correlated these findings with clinical outcome. Biopsies (n = 19) were evaluated by quantitative imaging analysis to measure steatosis and fibrosis. Most patients had decreased steatosis in their post-treatment, follow-up biopsies. However, one patient had a striking increase in steatosis (from 0.86 to 6.32%) and later developed decompensated cirrhosis and hepatocellular carcinoma (HCC). This patient had a marked increase in fibrosis between biopsies, with a CPA of 6.74 to 32.02. Another patient, who already had bridging fibrosis at the time of her pre-treatment biopsy, developed cholangiocarcinoma after DAA. Even though the overall inflammatory activity in the post-treatment biopsies significantly decreased after treatment, 60% of patients had persistent portal lymphocytic inflammation. In summary, DAAs decreased steatosis and hepatic inflammation in most patients, although some may have persistence of lymphocytic portal inflammation. Patients known to have advanced fibrosis at treatment initiation and who have other risk factors for ongoing liver injury, such as steatosis, should be followed closely for the development of adverse outcomes, such as portal hypertension and primary liver cancers.
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U2 - 10.1038/s41598-021-93881-7
DO - 10.1038/s41598-021-93881-7
M3 - Article
C2 - 34267267
AN - SCOPUS:85110753794
VL - 11
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
IS - 1
M1 - 14506
ER -