To address data limitations and methodological challenges in evaluating liver fibrosis outcomes, I led key analytic decisions throughout the project. When fibroscan data were insufficient, I proposed using FIB-4 scores—calculated from routine lab results—as a validated alternative to measure fibrosis severity. To assess differential treatment effects between patients with and without MASLD, I designed and implemented an mixed effects ordinal logistic regression model, incorporating interaction terms to evaluate changes in fibrosis risk categories over time. These methodological choices allowed us to rigorously examine real-world treatment outcomes using available electronic health record data.
In our real-world EHR analysis of 845 patients treated for chronic Hepatitis C (CHC) with direct-acting antivirals (DAAs), we observed significant liver fibrosis regression within one year of completing therapy. Notably, patients with co-existing MASLD experienced a greater reduction in fibrosis risk category, as measured by FIB-4 scores, compared to those without MASLD. The association between MASLD status and more pronounced fibrosis improvement was statistically significant.
Contrary to concerns that MASLD may hinder liver recovery, our study suggests that the presence of MASLD does not impair—and may even enhance—the benefit of fibrosis regression following DAA treatment for CHC. These findings highlight the importance of not excluding patients with metabolic liver conditions from receiving antiviral therapy and support further investigation into the biological mechanisms that may drive enhanced fibrosis improvement in this population.
Read more about the study: "Improved Liver Fibrosis Regression After Direct-Acting Antiviral Therapy in Hepatitis C Patients: A Comparison of Patients With and Without MASLD"