Efficacy and Safety of Ledipasvir/Sofosbuvir Therapy in HCV Genotype 1 Korean Patients

( Dong Hoon Lew ),( Wonseok Kang ),( Dong Hyun Sinn ),( Geum-youn Gwak ),( Yong-han Paik ),( Moon Seok Choi ),( Joon Hyeok Lee ),( Kwang Cheol Koh ),( Seung Woon Paik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Ledipasvir/sofosbuvir therapy has demonstrated potent antiviral activity in patients with genotype 1 chronic hepatitis C virus (HCV) infection, yet its efficacy has not been proved in a real-life cohort of Korean patients. We assessed efficacy and safety of ledipasvir/ sofosbuvir therapy in a real-life cohort of Korean patients with genotype 1 chronic HCV infection. We also aimed to study whether successful antiviral therapy leads to improvement of liver fibrosis. Methods: Between February 2016 and December 2016, a total of 39 patients with genotype 1 chronic HCV infection were retrospectively enrolled at Samsung Medical Center, Seoul, Korea. Clinical and laboratory findings were collected at baseline and 12 weeks after completion of treatment. Liver fibrosis status was assessed at baseline and at post-treatment week 12 using well-known non-invasive biochemical methods, including APRI (AST to Platelet Ratio Index) and FIB-4 (Fibrosis-4) indices. Results: Of 39 patients, 2 patients (5.1%) had genotype 1a and 37 (94.9%) had genotype 1b chronic HCV infection. Eighteen patients (46.2%) were treatment-naïve and 22 (56.4%) were treatment- experienced, including 2 patients who failed previous direct-acting antiviral treatment. Eight patients (20.5%) had cirrhosis. SVR12 was achieved in 39 patients (SVR12 100%). No serious adverse events were observed. A significant improvement of liver fibrosis status after achieving SVR12 as compared to baseline was demonstrated by APRI and FIB-4 indices (1.532 vs. 0.6351, P <0.001 and 5.392 vs. 3.553, P <0.01, respectively). Conclusions: Ledipasvir/sofosbuvir therapy has demonstrated high efficacy and safety for both treatment-naïve and treatment-experienced patients with HCV genotype 1 infection, including those who had previous exposure to other direct-acting antiviral agents. A significant improvement of liver fibrosis status was shown after achieving SVR12.

Efficacy and safety of ledipasvir/sofosbuvir in 5,028 Mongolian patients infected with genotype 1 hepatitis C virus: A multicenter study

( Oidov Baatarkhuu ),( Jae Seung Lee ),( Jazag Amarsanaa ),( Do Young Kim ),( Sang Hoon Ahn ),( Nyamsuren Naranzul ),( Damba Enkhtuya ),( Nagir Choijamts ),( Purev Batbayar ),( Radnaa Otgonbayar ),( B 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1

Background/Aims: Ledipasvir/sofosbuvir (LDV/SOF) shows high efficacy and safety in patients with genotype 1-hepatitis C virus (HCV). We aimed to investigate the efficacy and safety of LDV/SOF in real-world Mongolian patients. Methods: Between 2015 to 2019, 23 (0.5%) and 5,005 patients (99.5%) with genotype 1a and 1b HCV, respectively, were treated with a fixed-dose tablet containing 90 mg ledipasvir and 400 mg sofosbuvir for 12 weeks, and 81 patients (1.6%) with previous experience of interferon (IFN)-based treatment received additional 1,000 mg ribavirin. HCV RNA was measured at 4, 12, and 24 weeks after the first dose to determine rapid virologic response, end of treatment response (ETR), and sustained virologic response at 12 weeks after end of treatment (SVR12). Results: Most patients (n=5,008; 99.6%) achieved ETR and SVR12 without virologic relapse. Patients with genotype 1a showed low rates of ETR and SVR12 in only 16 patients (69.6%). There was no significant difference in SVR12 rate between patients regardless of IFN experience (n=81; 1.6%), cirrhosis (n=1,151; 22.9%), HCV RNA >6×10⁶ IU/mL (n=866; 17.2%), or liver stiffness >9.6 kPa (n=1,721; 34.2%) (100.0%, 99.3%, 99.4%, and 99.4%, respectively). No severe adverse events (AEs) were reported, and there was no dose reduction or interruption due to AE. The most common AEs were headache (n=472; 9.4%), fatigue (n=306; 6.2%), abdominal discomfort (n=295; 5.9%), and skin rash (n=141; 2.8%). Conclusions: LDV/SOF showed high efficacy and safety for patients with genotype 1, especially 1b HCV, in Mongolia. The real-world data might be applicable to patients in other Asian-Pacific countries. (Clin Mol Hepatol 2021;27:125-135)

Treatment Outcomes of Sofosbuvir-Based Therapy for Chronic Hepatitis C Genotype 1 and 2

( In Young Kim ),( Ja Kyung Kim ),( Jung Il Lee ),( Kwan Sik Lee ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: With the recent development of direct acting antivirals (DAA), DAA has become the standard treatment for chronic hepatitis C (CHC). However, domestic data regarding outcomes of DAA for CHC are lacking. The goal of this study was to analyze sofosbuvir-based treatment outcomes for CHC. Methods: Medical records of patients who were prescribed sofosbuvir-based therapy for the treatment of CHC were retrospectively reviewed. Patients who had available sustained virologic response (SVR) 12 were selected to analyze. Patients with CHC genotype 1 used ledipasvir/sofosbuvir for 12 weeks. Among them, who had liver cirrhosis (LC) or treatment experience used ribavirin together. Patients with CHC genotype 2 and LC used sofosbuvir- ribavirin combination therapy for 16 weeks, and those without LC used for 12 weeks. Results: Nine of 20 patients with CHC genotype 1 and 30 of 42 patients with CHC genotype 2 were finally enrolled. Among 9 patients with genotype 1, 8 (88.9%) infected with genotypes 1b and 1 (11.1%) with genotype 1a. Four (44.4%) had LC, and 4 (44.4%) with resistance-associated variants. Six (66.7%) patients were naïve. Eight (88.9%) patients achieved rapid virological response (RVR), and all patients achieved end-of-treatment response (ETR) and SVR 12. Among 30 patients with genotype 2, 22 (73.3%) infected with genotypes 2a, 2 (6.7%) with genotype 2a/2c, 1 (3.3%) with genotype 2b. Ten (33.3%) patients had LC. Twenty-three (79.8%) patients reached RVR, and all patients reached ETR. However, SVR12 achieved by 29 (96.6%) patients. One patient who failed the treatment had liver cirrhosis, hepatocellular carcinoma and prior interferon treatment failure history. There was no serious adverse event to discontinue the treatment. Conclusions: Sofosbuvir-based treatment showed optimal efficacy without serious adverse events. Long-term and large scaled study are warranted to ensure the sustained antiviral efficacy and safety of sofosbuvir-based therapy in HCV patients.

Sofosbuvir/Ledipasvir in the Treatment of Chronic Hepatitis C - A Subgroup Analysis from A Nationwide Real-World HCV Registry Program (TACR) in Taiwan

( Ming-Lung Yu ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ching-Chu Lo ),( Pin-Nan Cheng ),( Cheng-Yuan Peng ),( Ming-Jong Bair ),( Chih-Lang Lin ),( Chi-Ming Tai ),( Chi-Chieh Yang ),( Chih-Wen Lin ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: TASL HCV Registry (TACR) is a nationwide registry program organized and supervised by Taiwan Association for the Study of the Liver (TASL), which aims to setup the database and biobank of patients with chronic hepatitis C (CHC) in Taiwan. The present study aimed to evaluate the treatment outcome of sofosbuvir (SOF)/ledipasvir (LDV) in Taiwanese CHC patients in TACR. Methods: By May 2020, 19 tertiary hospitals, 23 community hospitals and one primary care clinic join the TACR program. The baseline characteristics, prior liver and non-liver related medical history, DAA regimens, laboratory results, treatment course and outcome were recorded. The primary objective was sustained virological response, defined as undetectable HCV RNA 3 months after end-of-treatment (SVR12). Results: A total of 4742 SOF/LDV+ ribavirin treated CHC patients with available SVR12 data from 39 sites were enrolled in the current analysis. The mean age was 61.3 years, and female accounted for 54.8% of the population. The dominant viral genotypes were GT1b (52.6%) and GT2 (35.6%). 1354 (28.6%) patients had liver cirrhosis, including 156 (3.3%) with liver decompensation, 552 (11.6%) had preexisting hepatocellular carcinoma (HCC) before DAAs treatment and 413 (8.7%) had hepatitis B virus dual infections. The overall SVR12 rate was 98.5%, with 98.5%, 98.2%, 99.7% and 98.6% in treatment- naïve non-cirrhotics, treatment-naïve cirrhotics, treatment- experienced non-cirrhotics and treatment-experienced cirrhotics patients, respectively. While patients were stratified by HCV genotype, the SVR12 was 98.5%, 98.4% and 98.5% among those with GT1, GT2 and GT6 infection, respectively. The strongest factor independent associated with treatment failure was DAA adherence < 60% (odds ratio [OR]/95% confidence intervals [CI]: 125.4/25.7-612.4, P<0.0001), followed by active HCC (OR/CI: 6.20/2.57-14.97, P<0.0001), HIV co-infection (OR/CI: 3.01/1.14-7.92, P=0.026), and male gender (OR/ CI: 1.85/1.09-3.13, P=0.023). The eGFR decreased significantly at the end of treatment (EOT) (89.3 ml/min/1.73㎡ vs. 93.2 ml/min/1.73㎡, P< 0.001) and remained stable 3 months after EOT (89.3 ml/min/1.73㎡). However, the decreased eGFR was observed only in patients whose baseline eGFR > 90 ml/ min/1.73㎡. Instead, patients with chronic kidney diseases whose pretreatment eGFR < 60 ml/min/1.73㎡ had improved eGFR after SOF/LDV. Conclusions: SOF/LDV is highly effective in treating CHC patients in real-world setting of Taiwan. The satisfactory result could be explicitly generalized to patients with different viral genotypes and liver disease severities.

Efficacy of Ledipasvir/Sofosbuvir plus Rivabirin among Patients with Decompensated Cirrhosis Who Underwent Liver Transplant during Participation in the SOLAR-1/-2 Studies

( Beat Müllhaupt ),( Paul Kwo ),( Kosh Agarwal ),( Christophe Duvoux ),( Francois Durand ),( Marcus Peck-Radosavljevic ),( Eric M. Yoshida ),( Leslie Lilly ),( Bernard Willems ),( Hugo Vargas ),( Prin 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: The aim of this analysis is to evaluate outcomes in patients who underwent liver transplant after initiating treatment with ledipasvir (LDV)/sofosbuvir (SOF)+ribavirin (RBV) in the SOLAR-1 and SOLAR-2 trials. Methods: We combined data from the SOLAR-1 and SOLAR-2 studies, in which 7 groups of patients with HCV genotype (GT) 1 or 4 were randomized to receive 12 or 24 weeks of LDV/SOF+ RBV: patients without a transplant with 1) Child-Pugh-Turcotte (CPT) B or 2) CPT C cirrhosis; or transplanted patients with 3) no cirrhosis (F0 to F3), 4) CPT A, 5) CPT B or, 6) CPT C cirrhosis, or 7) fibrosing cholestatic hepatitis. Results: Seventeen patients underwent liver transplantation during the study. For all but one patient, this was the first liver transplant. Six were CPT B at screening (5 Group 1, 1 Group 5) and 11 were CPT C (Group 2). Median baseline MELD score was 17 (range 7-23), with the majority (11/17) having scores ≥15. Seven patients underwent transplant prior to completing their full course of treatment. All patients were HCV RNA <LLOQ at the time of liver transplant. All but one patient (94%, 16/17) maintained virologic response 12 weeks after transplant (pTVR12). All patients who achieved pTVR12 received at least 11 weeks of LDV/SOF+RBV. The one patient who did not achieve pTVR12 discontinued study drug on day 21 and underwent liver transplant the following day. Conclusions: Few patients with decompensated cirrhosis treated in the SOLAR studies underwent liver transplantation after initiating LDV/SOF+RBV therapy. For the 17 who did undergo transplant, 94% achieved pTVR12. The data suggest that 11 weeks of treatment prior to transplantation can prevent reinfection of the graft. Future studies are needed to assess the optimal timing and length of treatment in the peri-transplant setting.

Asian Patients with Genotype 1 HCV Achieve 99% SVR with 12 Weeks of Ledipasvir/Sofosbuvir: Integrated Analysis of Phase 3 Studies

( Young-Suk Lim ),( Sang Hoon Ahn ),( Kwan Sik Lee ),( Seung Woon Paik ),( Youn-Jae Lee ),( Sook-Hyang Jeong ),( Ju-Hyun Kim ),( Seung Kew Yoon ),( Hyung Joon Yim ),( Won Young Tak ),( Sang-Young Han 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Background: Similar to the United States and Europe, the majorityof patients with chronic HCV infection in Japan, Korea, and Taiwanare infected with HCV genotype (GT) 1. However, important differencesin viral and host characteristics exist between the infected populationsin these regions, including age, BMI, IL28B genotype andHCV GT1 subtype. The aim of this integrated analysis is to evaluatethe efficacy and safety of ledipasvir/sofosbuvir (LDV/SOF) in a largecohort of Asian patients with chronic GT1 HCV infection.Methods: This analysis combines data from subjects enrolled in twoPhase 3 trials: GS-US-337-0113 (Japan) and GS-US-337-0131 (Koreaand Taiwan) evaluating 12 weeks of LDV/SOF (90mg/400mg) in treatment-naive and treatment-experienced adults with chronic GT1 HCVinfection. The primary efficacy endpoint was SVR12.Results: Overall, 349 subjects were enrolled in Korea, Taiwan, andJapan, 67 (19%) had cirrhosis. The majority were female (58%), treatment-experienced (51%), GT1b infected (94%), and IL28B CC (62%).The mean age (range) was 57 (18-80) years old, BMI 24 (17-38)kg/m2, and HCV RNA was 6.6 (3.7-7.6) log10 IU/mL. HCV NS5ARAVs were detected in 23% (80/343) of subjects at baseline. Theoverall SVR12 rate was 99% (346/349); 2 subjects relapsed and 1subject prematurely discontinued treatment. All treatment-experiencedsubjects with cirrhosis (45/45) achieved SVR12. NS5A RAVswere detected at the time of relapse but no NS5B RAVs were detected.Serious AE and treatment discontinuations were rare (<2%). Adverseevents were generally mild in severity. No significant laboratory abnormalitieswere observed.Conclusions: A single tablet regimen of LDV/SOF administered oncedaily for 12 weeks is highly effective and well tolerated in Asianpatients with chronic GT1 HCV infection, including those with compensatedcirrhosis. Prior HCV treatment experience

Resistance Analyses for Ledipasvir/Sofosbuvir Containing Regimens in HCV-infected Patients Who Have Advanced Liver Disease or Are Post Liver Transplant

( Michael Charlton ),( Michael Manns ),( Hadas Dvory-sobol ),( Evguenia Svarovskaia ),( Brian Doehle ),( Sarah Arterburn ),( Chohee Yun ),( Diana M. Brainard ),( John G. Mchutchison ),( Michael Miller 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Ledipasvir/sofosbuvir (LDV/SOF) with ribavirin (RBV) demonstrated high SVR rates in patients with chronic hepatitis C (HCV) genotype (GT) 1 or 4 infection who have decompensated cirrhosis or who have undergone liver transplantation. Here we evaluated the effect of baseline HCV NS5A and NS5B resistance-associated variants (RAVs) on treatment outcome and characterized the viral resistance in all virologic failures. Methods: Deep sequencing with a 1% assay cut-off was performed for NS5A and NS5B at baseline for all the patients and at the time of virologic failure for those who relapsed. Results: Out of 625, 622, and 619 samples were analyzed for baseline NS5A and NS5B respectively. Table 1 summarizes SVR12 rates by treatment duration and the presence or absence of baseline NS5A RAVs. NS5B RAVs at baseline were uncommon, occurring in 4.8% (28/586) GT1 patients and 3.2% (1/31) GT 4 patients. Of these 29 patients, only one GT1 patient with CPT C cirrhosis who had L159F at baseline and was treated for 24 weeks with LDV/SOF+RBV did not achieve SVR12. NS5A RAVs at positions 24, 28, 30, 31, 58, and 93 were enriched or emerged in 20/22 (91%) GT1 and 1/3 GT4 infected patients with virologic failure. The NS5B NI RAV E237G emerged in 3 GT1a patients and 1 GT4d patient at the time of relapse (4/23, 17%). Conclusions: The presence of baseline NS5A or NS5B RAVs did not impact the treatment outcome to 12 or 24 weeks of LDV/SOF+RBV in GT1 or GT4 HCV patients with liver ransplantation without decompensated liver disease, or 24 weeks of LDV/SOF+RBV in patients with decompensated cirrhosis. Lower SVR rates were observed among the limited number of patients with decompensated cirrhosis and baseline NS5A RAVs who received 12 weeks of LDV/SOF+RBV treatment.

Efficacy and Safety of Ledipasvir/Sofosbuvir Treatment of HCV Genotype 1b in Mongolia

( O. Baatarkuu ),( B. Enkhtuvshin ),( N. Lkhaasuren ),( B. Batsukh ),( G. Sarangua ),( D. Enkhtuya ),( N. Choijamts ),( J. Amarsanaa ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The incident of liver cancer in Mongolia generally caused by HBV and HCV, and it is 7 times higher than that of world average. HCV, the most prevalent cause of HCC in Mongolia, is number one public health issue. Mongolia is one of the first countries that registered ledipasvir/sofosbuvir (LDV/SOF) regimen from developing countries. By the support of Access program run by Gilead Sciences, USA, we started HCV treatment program from January 2016. Methods: We followed and evaluated treatment outcome of patients with HCV infection using combination of 90 mg ledispavir/400 mg sofosbuvir (manufactured by Gilead Science) in 937 treatment naive and 83 treatment experienced patients. All patients were treated with LDV/SOF for 12 weeks and, their treatment was evaluated by quantitative HCV-RNA assays prior and W (week) 4 and W12 of treatment. Sustained virological response (SVR) after 12 weeks treatment was assessed. Virus genotype analysis using cDNA microarray, liver enzymes, CBC and drug related adverse events were assessed in every patient. The laboratory tests were conducted at National Center of Communicable Diseases and Happy Veritas Laboratories. Results: We conducted largest ever (415/1020) HCV genotype (GT) distribution study in Mongolian chronic HCV patients. 96.6% (n = 401) of assessed patients were GT1b; 0.7% (n = 3) were GT2; 0.2% (n = 1) were GT1a and b; 0.9% (n = 4) were GT1b and 2; 0.5% (n = 2) were GT1b and 6; 0.2% (n = 1) were GT5 and 0.2% (n = 1) were GT1b and 80 k mutants respectively. 992/1020 (97.3%) patients achieved SVR12W, 28 (2.7%) patients who did not achieve SVR12 W were all genotype 1b. Median ALT level significantly dropped during treatment from 95.5 ± 84.1 IU/L to 27.2 ± 18.6 IU/L and slightly increased by the end of treatment 42.9 ± 17.4 IU/L. Total of 39 adverse events were observed in 595/1020 patients (58.3%). Single adverse events were observed in 401/1020 (39.3%) whereas 2 and more events were observed in 194 (19%) patients respectively. Unreported adverse events such as partial facial palsy, AFP (alpha-fetoprotein) increase, melasma were observed. Conclusions: Treatment of HCV in Mongolia using all-oral dual DAA was divided in 3 phases due to shortness of drugs and logistics arrangements. We were able to include only stage-one patients in this study. We achieved 97.3% SVR12W for 3 months treatment with LDV/SOF this time. But viral relapse has to be determined repeatedly at weeks 24 and 48 post treatment. All viral relapses (n = 14) and non-responders (n = 14) were GT1 in our study. According to HCV genotype assessment, there was no difference in treatment outcomes between patients who had different genotypes. HCV RNA clearance during treatment was no different than clinical trials, but the slight increase of ALT by the end of treatment was commonly observed. It might have happened due to rebound of immune reaction after clearance of HCV or a drug induced effect.

Ledipasvir and Sofosbuvir Fixed-Dose Combination without Ribavirin for 12 Weeks in Treatment-Naive Mongolian Patients with Hepatitis C: A Multi-Center Study

( O. Baatarkhuu ),( B. Davaakhuu ),( N. Naranzul ),( Ch. Gantuul ),( Ch. Bolormaa ),( P. Delgermaa ),( S. Ariunaa ),( G. Sarangua ),( G. Khishigjargal ),( D. Javzmaa ),( D. Ouyntuya ),( S. Nyamaa ),( 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: In Mongolia, previous studies shown HCV prevalence is over 10% and 97-98% of people with HCV infection have infected with genotype 1b. In addition, Mongolia is on first place of HCC mortality rate per 100.000 population and this is eighth times higher than globally average rate. HCV prevalence among primary hepatic carcinoma patients is 35%-45%. Therefore activities on reducing chronic infection prevalence of hepatitis viruses and preventing complications of hepatitis viral infections have been conducted in the country. One of them is availability of Harvoni treatment for HCV patients since December 2015. To evaluate data on the antiviral efficacy and safety of direct acting antiviral (DAA) treatment with respect to sustained virological response (SVR) 12 weeks after completion of treatment. Methods: We retrospectively analyzed patient monitoring records and patient registration forms for HCV patients who received Harvoni treatment at NCCD, MNUMS, provinces and districts hospitals. Quantitative methods were applied in that retrospective study. Six hundred and forty-seven patients diagnosed as HCV and treated by Harvoni(ledipasvir/sofosbuvir) were attended the study. Results: There were totally 647 patients received Harvoni for HCV infection by September 2016. People who received treatment for less than 3 months there 31% and for longer than 3 months were 8%. Among them 91.9% have chronic hepatitis and first stage of liver cirrhosis and 8% have liver cirrhosis and carcinoma. After 1 month of treatment, HCV RNA tests result was negative for 98.8% of all Harvoni patients and for the rest 1.1% resulted in decrease of HCV RNA.After 3 month of trerapy, blood test result showed 100% recovery on transaminase level. 453/465, 10/465 and 2/465 of them were respectively genotype 1b, 2 and 1a. APRI score were pre-treatment 1.3±0.58 and post treatment 0.443±0.148. FIB4 score were pre-treatment 3.8±1.2 and post treatment 1.65±0.59. Occurrences of side effects were mild. 1.2%, 5.8% and 4.6% of them were respectively with CTP C, CTP B and CTP A scores. 88.2% of the participants were chronic hepatitis C and 1.7% of them were pre-treated by interferon. Conclusions: After treatment by Harvoni tablets, excellent SVR12 results were shown among the study participants’ and the favorable side-effect profile were observed for the Mongolian context.

Liver Stiffness Decrease Post Ledipasvir/Sofosbuvir Combination Treatment in Mongolian Patients with Chronic Hepatitis C

( D. Munkh-orshikh ),( D. Enkhtuya ),( N. Choijamts ),( Ch. Gantuul ),( O. Baatarkhuu ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The prevalence of liver cancer in Mongolia is 7 times higher than that of world average, generally caused by HBV and HCV. The most prevalent cause of HCC in Mongolia, HCV, accompanied with liver stiffness and cirrhosis, is an emerging public health issue. Mongolia is one of the first countries that registered Ledipasvir/Sofosbuvir (LDV/SOF) regimen from developing countries. By the support of Access program run by Gilead Sciences, USA, we started HCV treatment program from January 2016. Methods: We followed and evaluated treatment outcome of patients with HCV infection using combination of 90 mg ledispavir/ 400 mg sofosbuvir (manufactured by Gilead Science) in 298 treatment nai¨ve patients. All patients were treated with LDV/SOF for 12 weeks and, their treatment was evaluated by quantitative HCV-RNA assays prior and W (week) 4 and W12 of treatment. Sustained virological response (SVR) after 12 weeks treatment was assessed. Virus genotype analysis using cDNA microarray, liver enzymes, CBC and drug related adverse events were assessed in every patient. The laboratory tests were conducted at National Center of Communicable Diseases and Happy Veritas Laboratories. Results: Out of 298 patients underwent treatment, 138 patients were examined for pre-treatment liver stiffness using Fibroscan. When patients were examined by Fibroscan test, 25% (n = 35) of assessed patients were F0 stage; 13.57% (n = 19) were F1 stage; 10% (n = 14) were F2 stage; 20.71% (n = 29) were F3 stage; and 30.72% (n = 43) were F4 stage. Patients (n = 35) with fibrosis stage F0 were omitted from post-treatment control examinations. The one hundred three patients were selected for further post-treatment fibrosis staging. The twenty three patients were successfully contacted and complied posttreatment Fibroscan scanning. 23/23 (100%) patients achieved SVR12. W, were all genotype 1b. Median ALT level significantly dropped during treatment from 121.19 ± 98.3 IU/L to 33.2 ± 14.7 IU/L and slightly increased by the end of treatment 41.4 ± 18.8 IU/L. The ninety one percent of the patients had improved in liver stiffness while remaining patients were observed increased stiffness. Conclusions: After treatment, 30.43% (n = 7) of patients moved to the F0 stage from liver stiffness. There are many studies that assess liver fibrosis after cure of HCV, but varying numbers were observed. We assess liver stiffness after treatment of HCV in Mongolian population for the first time. Though study population was small, we had 91% of.