Evaluation of LiverRisk score as predictor of liver fibrosis and mortality in patients with HCV-related hepatitis treated with direct acting antivirals

Abstract

Introduction

The LiverRisk score has been recently developed and validated as a predictor of liver fibrosis and liver-related outcomes in the general population. This score has never been evaluated as predictor of liver fibrosis and outcomes in secondary care, such as in patients with chronic liver diseases.

AIM

The aim of this study was to evaluate the role of the LiverRisk score as a predictor of liver fibrosis and mortality in patients with HCV-related hepatitis treated with direct acting antivirals (DAA).

Methods

patients were enrolled retrospectively, outpatients with chronic hepatitis C treated with DAA between 2015 and 2017 were included consecutively. Patients were followed-up until September 2023. The exclusion criteria were: liver transplantation before DAAs and presence of HCC. Patient characteristics and LiverRisk score were collected before starting the DAA. The data for the calculation of LiverRisk score were collected the same day the fibroscan was performed. The primary endpoint was a liver stiffness ≥10 kPa. Area under the receiver operating characteristic (AUROC) curve was evaluated for assessing the discrimination ability of Liver Risk score. Overall mortality was assessed at the end of follow-up.

Results

in this ongoing study, 136 patients of our center with chronic hepatitis C treated with DAA were enrolled. In this population, 51% were men, the mean age was 65.3±12.2 years, 65.4% were genotype 1, 59.6% had liver cirrhosis, the mean liver stiffness measurement was 15.9 KPa (3.5-48.8), sustained virological response (SVR) was 95.5% and the mean follow-up was of 59 months. Coinfection with hepatitis B virus (HBV) was present in 8.8%. Discrimination ability of the LiverRisk score in the prediction of liver stiffness ≥10KPa was very good as shown by an AUROC of 0.848 (95% confidence interval [CI] = 0.767-0.930; p=0.000). During follow up 21 patients (15.4%) died. LiverRisk score was associated with the risk of all cause of mortality (Hazard Ratio = 1.154; 95% CI = 1.01–1.318; p = 0.035).

Conclusion

the liver risk score is a good predictor of fibrosis and mortality in HCV patients treated with DAA.