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.
丙型肝炎直接作用抗病毒药物（DAAs）治疗后肝活组织检查病理学评价临床意义重要。DAAs治疗获得持续病毒学应答后，肝脏炎症坏死通常逐渐消退，固有的肝纤维化等病变成为组织学评价的焦点；各指南中推荐的组织学评价系统适合DAAs治疗后无病毒状态丙型肝炎组织学评价，但会出现炎症分级与纤维化分期"分离"现象，建议同时采用α-平滑肌肌动蛋白免疫组织化学染色以评价肝纤维化活动度。肝组织内HCV RNA的检测是判断DAAs治疗后病毒完全清除的"金标准"，建议采用RNAscope技术、RT-PCR等技术进行肝组织内HCV RNA检测；针对DAAs治疗获得持续病毒学应答后肝纤维化逆转、消退、稳定或加重不同转归的人群，如何通过无创诊断技术方法予以甄别是临床有待解决的问题。.
Keywords: Direct-acting antiviral agents; Evaluation; Hepatitis C; Liver; Pathology.