Histopathology and the predominantly progressive, indeterminate and predominately regressive score in hepatitis C virus patients after direct-acting antivirals therapy

Table 1 Clinical and histological characteristic of hepatitis C virus patients before treatment (n = 38)

Parameters
Age (yr)	40.9 ± 14.6
Males, n (%)	20 (53)
ALT (U/L)	54 (30)
TBil (μmol/L)	11.5 (6.7)
Albumin (g/L)	45.7 ± 3.5
Platelets (× 103 μL)	173.6 ± 63.6
INR	1.00 (0.10)
HCV RNA (log IU/L)	6.24 ± 0.79
LSM, kPa	6.6 (3.6)
HCV genotype
1	23 (60)
2	3 (8)
3	12 (32)
Treatment, n (%)
SOF + RBV	17 (45)
DCV + ASV	14 (37)
GZR + EBR	7 (18)
HAI score, n (%)
0-3	6 (16)
4-6	12 (32)
7-9	9 (24)
≥ 10	11 (29)
Ishak score, n (%)
F0-2	8 (21)
F3-4	17 (45)
F5-6	13 (34)

ALT: Alanine aminotransferase; TBil: Total bilirubin; INR: International normalized ratio; HCV: Hepatitis C virus; LSM: Liver stiffness measurement; SOF + RBV: Sofosbuvir + ribavirin; DCV + ASV: Daclatasvir + asunaprevir; GZR + EBR: Grazoprevir + elbasvir; HAI: Histology activity index.

Table 2 Clinical and pathological parameters of hepatitis C virus patients by pretreatment and posttreatment predominantly progressive, indeterminate and predominately regressive score (n = 23)

Parameters	Progressive	Indeterminate	Regressive	P value
Pretreatment, n (%)	15 (65)	7 (30)	1 (4)
Age (yr)	50.3 ± 12.3	43.9 ± 12.5	27.0	0.154
Males, n (%)	6 (40)	3 (43)	0 (0)	0.709
ALT (U/L)	66 (57)	48 (38)	50 (0)	0.469
TBil (μmol/L)	14.0 (8.0)	12.0 (6.0)	9.0 (0.0)	0.642
Albumin (g/L)	44.0 ± 3.9	47.0 ± 3.1	45.0	0.233
Platelets (× 103 μL)	129.3 ± 60.2	188.0 ± 51.5	268.0	0.024
INR	1.04 (0.16)	1.00 (0.2)	1.00 (0.00)	0.307
HCV RNA (log IU/L)	6.01 ± 0.66	6.46 ± 0.90	6.60	0.375
LSM, kPa	8.8 (14.8)	6.6 (2.9)	6.6 (0.0)	0.331
HAI score, n (%)				0.070
0-3	0 (1)	1 (14)	0 (0)
4-6	1 (7)	2 (29)	1 (100)
7-9	4 (27)	3 (43)	0 (0)
≥ 10	10 (67)	1 (14)	0 (0)
Ishak score, n (%)				0.072
3-4	4 (27)	5 (71)	1 (100)
5-6	11 (73)	2 (29)	0 (0)
Posttreatment, n (%)	5 (22)	9 (39)	9 (39)
Age (yr)	50.4 ± 12.0	47.8±14.1	45.4 ± 13.4	0.802
Males, n (%)	1 (20)	3 (33)	5 (56)	0.384
ALT (U/L)	25 (21)	17 (8)	15 (15.5)	0.340
TBil (μmol/L)	19 (10)	10 (6)	14 (9)	0.149
Albumin (g/L)	44.0 ± 4.2	44.9 ± 1.9	46.0 ± 1.8	0.353
Platelets (× 103 μL)	156.4 ± 63.3	184.4 ± 80.3	151.1 ± 65.8	0.552
INR	1.13 (0.15)	1.00 (0.14)	1.09 (0.15)	0.052
LSM, kPa	11.5 (22.8)	7.8 (7.4)	6.8 (5.2)	0.683
HAI score, n (%)				0.338
0-3	1 (20)	4 (44)	6 (67)
4-6	2 (40)	4 (44)	3 (33)
7-9	1 (20)	0 (0)	0 (0)
≥ 10	1 (20)	1 (11)	0 (0)
Ishak score, n (%)				0.339
3-4	2 (40)	6 (67)	6 (67)
5-6	3 (60)	3 (33)	3 (33)

ALT: Alanine aminotransferase; TBil: Total bilirubin; INR: International normalized ratio; HCV: Hepatitis C virus; LSM: Liver stiffness measurement; HAI: Histology activity index.

Table 3 Posttreatment predominantly progressive, indeterminate and predominately regressive score vs changes in Ishak stage to evaluate disease progression or regression (n = 23)

Ishak (pre-post)	Posttreatment P-I-R score (n = 23)
	Progressive (n = 5)	Indeterminate (n = 9)	Regressive (n = 9)
Increase (n = 1)	Absolutely advancing 100% (1 of 1)	0	0
Stable (n = 18)	Probably advancing 22% (4 of 18)	33% (6 of 18)	Probably reversing 44% (8 of 18)
Decrease (n = 4)	0	75% (3 of 4)	Absolutely reversing 33% (1 of 3)

P-I-R: Predominantly progressive, indeterminate and predominately regressive.

Table 4 The three fibrosis scoring or staging systems of the 8 “probably reversing” cases

Case No.	P-I-R		Ishak score		LSM (kPa)
	Pre	Post	Pre	Post	Pre	Post
1	P	R	6	6	6.8	6.1
2	P	R	6	6	7.4	5.6
3	I	R	3	3	4.9	4.1
4	P	R	6	6	24.2	27
5	P	R	5	5	6.3	3.6
6	I	R	4	4	5.8	5.6
7	P	R	6	6	14.0	10.7
8	I	R	5	5	6.9	7.6

P-I-R: Predominantly progressive, indeterminate and predominately regressive; P: Progressive; I: Indeterminate; R: Regressive; LSM: Liver stiffness measurement; Pre: Pretreatment; Post: Posttreatment.