Abstract
The histological assessment of liver biopsy in chronic hepatitis C patients after direct-acting antiviral agents(DAAs) treatment plays a key role in evaluation of response to therapy. Liver necro-inflammation gradually subsides in patients who achieved sustained virologic response after DAAs treatment, thus the histological assessment focus on evaluating remission of liver fibrosis and other lesions. However, the evaluation of liver inflammation and fibrosis are usually inconsistent when the histological scoring systems are recommended by the clinical practice guidelines and applied in chronic hepatitis C patients who achieved viral clearance after DAAs therapy. Therefore, an immunohistochemical staining of α-smooth muscle actin is recommended to evaluate the activity of liver fibrosis. The gold standard for determining the complete clearance of virus after DAAs treatment is detection of HCV RNA in liver tissues. RNAscope technology and RT-PCR technique and other technologies are the powerful means of detecting HCV RNA in liver tissues. The implementation of non-invasive diagnostic techniques in clinic for the screening of liver fibrosis after DAAs therapy is problematic.