{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T11:51:55Z","timestamp":1773661915580,"version":"3.50.1"},"reference-count":107,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Technology and Science Foundation (FCT)","award":["PDE\/BDE\/114585\/2016"],"award-info":[{"award-number":["PDE\/BDE\/114585\/2016"]}]},{"name":"Technology and Science Foundation (FCT)","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Technology and Science Foundation (FCT)","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Foundation for Science and Technology to ISAMB","award":["PDE\/BDE\/114585\/2016"],"award-info":[{"award-number":["PDE\/BDE\/114585\/2016"]}]},{"name":"Foundation for Science and Technology to ISAMB","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Foundation for Science and Technology to ISAMB","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]},{"name":"Institute for Scientific Research Bento Rocha Cabral","award":["PDE\/BDE\/114585\/2016"],"award-info":[{"award-number":["PDE\/BDE\/114585\/2016"]}]},{"name":"Institute for Scientific Research Bento Rocha Cabral","award":["UIDB\/04295\/2020"],"award-info":[{"award-number":["UIDB\/04295\/2020"]}]},{"name":"Institute for Scientific Research Bento Rocha Cabral","award":["UIDP\/04295\/2020"],"award-info":[{"award-number":["UIDP\/04295\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Introduction: Chronic hepatitis C (CHC) is a clinical and pathological syndrome with various causes and is characterized by varying degrees of hepatocellular necrosis and inflammation. It is a significant cause of liver transplantation and liver-related death worldwide. The hepatic manifestations of CHC are typically characterized by slowly progressing liver fibrosis, which is a non-specific and often disproportionate response to tissue damage. A large majority of HCV patients have extrahepatic manifestations with varying degrees of severity. HCV infection is a risk factor for cardiovascular disease and diabetes mellitus, which increases insulin resistance, oxidative stress, and iron overload and causes chronic systemic inflammation. HCV infection is treated using direct-acting antivirals (DAAs) with cure rates of over 95 percent, minimal side effects, and shorter therapeutic courses. Despite the effective elimination of the virus, it seemed pertinent to understand to what extent HCV clearance eliminates or attenuates all the systemic alterations already induced by the virus during infection and chronicity. Objectives: Our study aimed to determine whether eliminating HCV with DAAs alters the severity of liver disease (liver stiffness and liver fibrosis stage by TE) and the metabolic\/cellular profile of patients with CHC. Materials and methods: A group of 329 CHC patients from a Gastroenterology and Hepatology outpatient department were prospectively studied. Of these, 134 were also studied with DAAs. The liver fibrosis stage was evaluated by transient elastography (TE) using a FibroScan\u00ae device, and two groups were established for the analysis of liver stiffness (LS): mild and moderate stiffness (fibrosis F1 and F2; F1\/2) and severe stiffness (fibrosis and cirrhosis F3 and F4; F3\/4). Metabolic\/cellular parameters were evaluated before and after antiviral treatment using standard methods: alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), \u03b3-glutamyl-transpeptidase (\u03b3-GT), haptoglobin (Hp), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), free iron (Fe), transferrin saturation (TS), total iron binding capacity (TIBC), ferritin (Ft), glycemia, insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and platelets count. The results were statistically analyzed using SPSS 24.0 for Windows. Results: Comparing the fibrosis stage before and after DAAs treatment, we verify a reduction in LS in 85.7% of patients and an improvement in liver fibrosis stage in 22.2% of them after DAAs treatment. Before DAAs treatment, patients showed a 2.410 risk for higher fibrosis stages (F3\/4). Comparing metabolic\/cellular parameters before and after DAAs treatment, patients showed lower ALP, AST, ALT, \u03b3GT, TG, Fe, TIBC, and Ft values and higher TC, LDL, and Hp values after treatment. As such, HCV elimination reduces iron overload and insulin resistance. On the other hand, it caused dyslipidemia, raising total cholesterol and LDL to levels outside the reference values. The improvement in the liver fibrosis stage by TE was mainly associated with higher baseline platelet count and HDL values and lower insulin resistance. Conclusions: With this study, we were able to contribute to the knowledge of the effects of HCV elimination with DAAs on liver disease and metabolic profile to improve the quality of treatment and follow-up of these patients after HCV elimination.<\/jats:p>","DOI":"10.3390\/v16030371","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T11:52:55Z","timestamp":1709034775000},"page":"371","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effects of HCV Clearance with Direct-Acting Antivirals (DAAs) on Liver Stiffness, Liver Fibrosis Stage and Metabolic\/Cellular Parameters"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-3274","authenticated-orcid":false,"given":"Joana","family":"Ferreira","sequence":"first","affiliation":[{"name":"Institute for Scientific Research Bento Rocha Cabral, 1250-047 Lisbon, Portugal"},{"name":"TERRA, ISAMB, Genetics Laboratory, Lisbon Medical School, University of Lisbon, 1649-028 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5773-5687","authenticated-orcid":false,"given":"Manuel","family":"Bicho","sequence":"additional","affiliation":[{"name":"Institute for Scientific Research Bento Rocha Cabral, 1250-047 Lisbon, Portugal"},{"name":"TERRA, ISAMB, Genetics Laboratory, Lisbon Medical School, University of Lisbon, 1649-028 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8542-2840","authenticated-orcid":false,"given":"F\u00e1tima","family":"Serejo","sequence":"additional","affiliation":[{"name":"TERRA, ISAMB, Genetics Laboratory, Lisbon Medical School, University of Lisbon, 1649-028 Lisbon, Portugal"},{"name":"Gastroenterology and Hepatology Department, Hospital de Santa Maria, 1649-028 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1002\/hep.1840190629","article-title":"Classification of chronic hepatitis: Diagnosis, grading and staging","volume":"19","author":"Desmet","year":"1994","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S2468-1253(16)30181-9","article-title":"Global prevalence and genotype distribution of hepatitis C virus infection in 2015: A modelling study","volume":"2","author":"Blach","year":"2017","journal-title":"Lancet Gastroenterol. 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