Comparative Changes in Fib-4 Score Before and After Taking Sofosbuvir and Daclatasvir in Hepatitis C Patients

Kainaat Ghalib; Ali Hamza; Syed Babar Hussnain; Nimra Ghalib; Jazib Ali

doi:10.54112/bcsrj.v6i2.2254

Authors

Kainaat Ghalib Department of Medicine (Unit 1), Aziz Bhatti Shaheed Teaching Hospital, Gujrat, Pakistan
Ali Hamza Ehsan Medical Clinic and Maternity Home, Gujrat, Pakistan
Syed Babar Hussnain Department of Medicine (Unit 1), Aziz Bhatti Shaheed Teaching Hospital, Gujrat, Pakistan
Nimra Ghalib Department of Medicine (Unit 1), Aziz Bhatti Shaheed Teaching Hospital, Gujrat, Pakistan
Jazib Ali Nazir Medical Clinic Gujrat, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i2.2254

Keywords:

Hepatitis C, Chronic; Sofosbuvir; Daclatasvir; Liver Cirrhosis; Biomarkers; Platelet Count

Abstract

Chronic hepatitis C virus (HCV) infection remains a major cause of liver-related morbidity and mortality, particularly in high-burden countries such as Pakistan. The Fibrosis-4 (FIB-4) index is a simple non-invasive marker derived from age, aspartate aminotransferase, alanine aminotransferase, and platelet count, and is widely used for assessment of liver fibrosis. Although sofosbuvir and daclatasvir are established as effective direct-acting antiviral agents, local evidence regarding their effect on FIB-4 score remains limited. Objective: To compare FIB-4 scores before and after treatment with sofosbuvir and daclatasvir in patients with chronic hepatitis C. Methods: This comparative pre- and post-treatment study was conducted at Aziz Bhatti Shaheed Teaching Hospital, Pakistan, from July 2024 to December 2024. A total of 100 adult patients with serologically and/or molecularly confirmed chronic hepatitis C were enrolled through non-probability consecutive sampling. Patients received standard-dose sofosbuvir plus daclatasvir according to institutional protocol. Baseline and post-treatment laboratory parameters, including aspartate aminotransferase, alanine aminotransferase, platelet count, bilirubin, albumin, and hemoglobin, were recorded, and FIB-4 scores were calculated using the standard formula. Data were analyzed using SPSS version 26. Pre- and post-treatment comparisons were performed using paired sample t-test or Wilcoxon signed-rank test as appropriate. A p-value of ≤0.05 was considered statistically significant. Results: The mean age of participants was 44.8 ± 11.6 years, with 54.0% males and 46.0% females. The mean FIB-4 score decreased significantly from 2.98 ± 1.21 before treatment to 1.86 ± 0.88 after treatment (p<0.001). Significant improvements were also observed in aspartate aminotransferase, alanine aminotransferase, platelet count, bilirubin, and albumin levels. The proportion of patients in the low-risk FIB-4 category increased from 39.0% before treatment to 68.0% after treatment, while the high-risk category decreased from 26.0% to 10.0%. End-of-treatment virological response was achieved in 92.0% of patients. Greater reductions in FIB-4 score were observed among younger, non-cirrhotic, and treatment-naïve patients. Conclusion: Sofosbuvir plus daclatasvir was associated with significant improvement in FIB-4 score and liver biochemical parameters in patients with chronic hepatitis C. The findings suggest that FIB-4 may serve as a practical and accessible tool for monitoring fibrosis-related improvement following antiviral therapy in routine clinical practice.

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