HCV direct acting antiviral treatment leads to highly durable rates of ALT and AST lower than 30/19 criteria and improved APRI and FIB‐4 scores

Direct acting antiviral treatment (DAA) has been the standard of care for hepatitis C virus (HCV) infection, but its long‐term benefits in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) improvement and hepatic fibrosis assessed by aspartate aminotransferase–to–platelet ratio index (APRI) and Fibrosis‐4 index (FIB‐4) scores remain unknown. The purpose of the present study was to assess DAA's long‐term benefits, including frequencies of posttreatment week 96 ALT/AST < 30 (males)/19 (females) (<30/19), improvement of APRI and FIB‐4 scores, and the associated factors. This was a single‐center, retrospective study on 157 patients with HCV with DAA‐mediated sustained virological response (SVR) 12. At posttreatment week (post‐Rx wk) 96, 75.4% had ALT < 30/19; 62.7%, AST < 30/19; and 60.1%, both ALT/AST < 30/19. ALT/AST < 30/19 at post‐Rx wk 96 was associated with ALT/AST < 30/19 at post‐Rx wk 12 (p = 0.026), independently of Child‐Turcotte‐Pugh < 6 (p = 0.862), platelets ≤ 120 × 10(9)/L (p = 0.343). Improvement rates of APRI < 0.5 and FIB‐4 < 1.45 from baseline to post‐Rx wk 96 were from 30.9% to 80.5%, and from 23% to 37.8%, respectively. Both APRI and FIB‐4 improvement was associated with both ALT/AST < 30 (males)/19 (females) at post‐Rx wk 12 (p = 0.012 and 0.011, respectively). Conclusion: The present study showed that DAA‐mediated SVR12 in patients with HCV resulted in (1) high and durable rates of ALT (75.4%), AST (62.7%), and both ALT/AST (60.1%) < 30/19, and (2) high rates of APRI < 0.5 (80.5%) and FIB‐4 < 1.45 (37.8%) at post‐Rx wk 96, demonstrated clinical value of ALT/AST < 30/19 and excellent long‐term outcomes of DAA‐mediated SVR12 in these patients.