DISTRIBUTION OF LIVER FIBROSIS AND STEATOSIS GRADES IN A COHORT OF PEOPLE WITH HEPATITIS C: LIVER ELASTOGRAPHY DATA AND QUANTITATIVE USFF ANALYSIS

Chronic hepatitis C virus (HCV) infection is a major cause of liver disease worldwide and may progress to advanced fibrosis, cirrhosis, and hepatocellular carcinoma. With the advent of direct-acting antivirals (DAAs), sustained virological response (SVR) has become achievable for most individuals. However, assessment of residual fibrosis and hepatic steatosis remains essential, particularly in those with advanced disease. Two-dimensional shear wave elastography (2D-SWE) enables noninvasive liver stiffness measurement, while ultrasound-derived fat fraction (USFF) allows objective steatosis quantification. This study aimed to describe the socioepidemiological profile and distribution of fibrosis and steatosis grades in individuals monoinfected with HCV. A retrospective cross-sectional study including 265 HCV-monoinfected individuals evaluated between January 2024 and June 2025. Variables included sex at birth, age, body mass index (BMI), liver stiffness (kPa) by 2D-SWE, and steatosis grade (S0–S3) by USFF, both performed using the Samsung RS85 Prestige platform. Fibrosis was classified using the Metavir system (F0–F4). Statistical analyses used Mann-Whitney and chi-square tests. Of the 265 participants, 234 (88.3%) had achieved SVR after DAA therapy, and 31 (11.7%) were treatment-naïve. Mean age was 62 years, 54% were male, and median BMI was 26.8 kg/m². Fibrosis distribution was F0 (36.6%), F1 (14.7%), F2 (13.2%), F3 (9.4%), and F4 (26.0%). Most participants showed absence of steatosis (S0), including those with advanced fibrosis. Individuals with mild to moderate fibrosis (F0–F2) more frequently presented grade 3 steatosis. No statistically significant association between fibrosis and steatosis grades was observed (p=0.76). The cohort showed a low prevalence of significant hepatic steatosis, even among individuals with advanced fibrosis. This finding may reflect specific metabolic characteristics or suggest hepatic “burnout” in advanced disease stages. The combination of 2D-SWE and USFF proved to be an effective noninvasive tool for monitoring and clinical risk stratification in people with HCV, particularly in post-SVR follow-up.