The change of hepatic iron accumulation and hepatic steatosis after DAAs-based therapy in patients with hepatitis C

2018 Fiscal Year Final Research Report

• Project/Area Number: 17K15900
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Yokohama City University
• Principal Investigator: Wataru Tomeno 横浜市立大学, 医学研究科, 客員講師 (00644957)
• Research Collaborator: SAITO Satoru
• Project Period (FY): 2017-04-01 – 2019-03-31
• Keywords: C型慢性肝炎 / 肝硬度 / MRエラストグラフィ / 鉄代謝 / 脂質代謝

Outline of Final Research Achievements

We assessed liver stifness (LS), hepatic iron accumulation(R2*), and hepatic steatosis using magnetic resonance elastography (MRE) before and after direct acting antivirals (DAAs)-based therapy in 52 patients with chronic hepatitis C. We assessed MRE before the treatment, at end of treatment, and 6 months after the treatment. The liver stiffness continued improving after normalization of the ALT. However, this improvement of the LS might be affected with the improvement of the liver inflammation, because the percent improvement of the LS was bigger in the patients whom ALT before the treatment was high (>30 IU/L) in. Regardless of the value of the ferritin having decreased, hepatic iron accumulation estimated by the values of R2* was constant after eradication of the hepatitis C virus. Hepatic steatosis was constant after the antiviral therapy, but there were few cases with the severe fatty liver before the treatment.

Free Research Field

ウイルス性肝炎

Academic Significance and Societal Importance of the Research Achievements

C型慢性肝炎に対する治療薬の進歩によって、ウイルス排除後を達成できたC型慢性肝炎患者は今後も増加していくことが予想される。今回の研究で肝内鉄沈着や脂肪化はウイルス排除後もすぐには改善しないことが判明し、ウイルス排除後の発癌リスクとなっている可能性がある。今後も長期経過を解析することで発癌の高リスク群の絞り込みに応用でき、適切なフォローアップ方法を提供することができれば、患者の精神的・経済的負担や医療経済への負担軽減につながる可能性がある。