Evolution of Liver Fibrosis in Romanian HCV Patients Following Treatment with Direct-Acting Antivirals

<b>Background/Objectives</b>: This study was conducted in an infectious disease clinic in southeastern Romania on a cohort of patients with chronic hepatitis C virus (HCV) infection. It aims to longitudinally evaluate biochemical parameters and the progression of liver fibrosis following treatment with direct-acting antivirals. <b>Methods</b>: One hundred eighty-one patients who experienced improvement in hepatic fibrosis 1-8 years after treatment (group A) were compared with eighty-six patients (except F0-F1) who had stable fibrosis or experienced worsening of hepatic fibrosis after antiviral treatment (group B). <b>Results</b>: The study demonstrated improvement and normalization of mean biochemical parameters in both groups, starting 4 weeks after initiation of therapy and remaining stable up to 5 years post-treatment. The only biochemical parameter that did not return to normal values was serum glucose, which showed elevated mean levels in both groups, with the highest values observed at 5 years post-treatment. Among all 267 patients, 181 (67.79%) showed improvement in hepatic fibrosis after DAA (direct-acting antivirals) therapy, 62 (23.22%) had stable fibrosis, and 24 (8.98%) experienced fibrosis worsening. Of those with improvement, 115 (63.53%) improved by one fibrosis stage, 49 (27.07%) by two stages, and 17 (9.39%) by three stages. <b>Conclusions</b>: This study highlights that more than half of Romanian HCV patients experienced regression of hepatic fibrosis and sustained normalization of most biochemical parameters up to 5 years after DAA treatment, confirming the long-term hepatic benefits of antiviral therapy.