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    Direct-acting antiviral therapy may help restore HCV-induced impaired redox balance and liver fibrosis process
    (Walter De Gruyter Gmbh, 2023) Bal, Tayibe; Dogan, Serdar; Ozcan, Oguzhan; Cabalak, Mehmet; Cirkin, Berfin
    Objectives: The aim of this study was to investigate the changes in thiol/disulfide balance, pro-fibrotic mediators (transforming growth factor-beta [TGF-beta] and periostin) and a potential biomarker for the prediction of HCV-induced HCC (3 beta-hydroxysterol Delta 24-reductase [DHCR24]) during direct-acting antiviral (DAA) therapy in chronic hepatitis C (CHC) patients. Methods: This prospective cohort study included 56 non-cirrhotic, treatment-naive CHC patients who were treated with DAAs between January and June 2020. Laboratory tests, including serum total/native thiol, TGF-beta, periostin, DHCR24, total bilirubin and albumin levels were measured and disulfide levels were calculated at baseline, then at 1 month and at the end of therapy (EOT). Results: Of the 56 patients, all achieved a sustained virological response after DAA therapy. There was a significant decrease in serum levels of disulfide and TGF-beta, (p=0.020 and p<0.001, respectively) and a significant increase in serum levels of native thiol compared with baseline levels (p=0.010). There was no significant change in levels of total thiol, DHCR24 and periostin levels. Serum TGF-beta levels were found to be positively correlated with total bilirubin levels (r(s)=0.470, p=0.001) and negatively with albumin levels (r(s)=-0.483, p<0.001). Asignificant moderate positive correlation was determined between baseline serum DHRC24 and disulfide levels (r(s)=0.356, p=0.007). Conclusions: The study results suggest that the DAA therapy may help to restore the impaired thiol/disulfide balance and reduce the pro-fibrotic process in CHC patients by markedly decreasing serum levels of TGF-beta, a key player in HCV-induced liver fibrosis.