BACKGROUND & AIMS: No published study to date has provided a careful analysis of the effects of a sustained viral response (SVR) on the outcomes of patients with compensated hepatitis C virus (HCV)-related cirrhosis in relation to the degree of portal hypertension. Therefore, we estimated the impact of achieving SVR on disease progression, hepatocellular carcinoma (HCC) development and mortality in a large cohort of HCV patients with cirrhosis with or without oesophageal varices (OVs) at the start of antiviral therapy. METHODS: A total of 535 Caucasian patients were prospectively recruited to this study. All patients had a clinical or histological diagnosis of compensated HCV-related cirrhosis and underwent interferon-based therapy. Competing risks and a multistate model were analysed according to the presence or absence of OVs at baseline. RESULTS: Compared to patients without SVR, a greater proportion of patients who achieved SVR showed no liver disease progression after 10 years (36.3% vs. 61.3% of patients without baseline OVs; 29.6% vs. 64.3% of patients with baseline OVs). Achievement of SVR was significantly associated with reduced occurrence rates of de-novo OVs, hepatic decompensation and HCC. Compared to patients without SVR, patients with SVR had lower likelihoods of liver-related death at 10 years (20.6% vs. 10.3% of patients without baseline OVs; 50.5% vs. 21.8% of patients with baseline OVs). CONCLUSIONS: In patients with compensated HCV-related cirrhosis with or without OVs at baseline, SVR is associated with reduced disease progression and liver-related mortality.
BACKGROUND & AIMS: No published study to date has provided a careful analysis of the effects of a sustained viral response (SVR) on the outcomes of patients with compensated hepatitis C virus (HCV)-related cirrhosis in relation to the degree of portal hypertension. Therefore, we estimated the impact of achieving SVR on disease progression, hepatocellular carcinoma (HCC) development and mortality in a large cohort of HCVpatients with cirrhosis with or without oesophageal varices (OVs) at the start of antiviral therapy. METHODS: A total of 535 Caucasian patients were prospectively recruited to this study. All patients had a clinical or histological diagnosis of compensated HCV-related cirrhosis and underwent interferon-based therapy. Competing risks and a multistate model were analysed according to the presence or absence of OVs at baseline. RESULTS: Compared to patients without SVR, a greater proportion of patients who achieved SVR showed no liver disease progression after 10 years (36.3% vs. 61.3% of patients without baseline OVs; 29.6% vs. 64.3% of patients with baseline OVs). Achievement of SVR was significantly associated with reduced occurrence rates of de-novo OVs, hepatic decompensation and HCC. Compared to patients without SVR, patients with SVR had lower likelihoods of liver-related death at 10 years (20.6% vs. 10.3% of patients without baseline OVs; 50.5% vs. 21.8% of patients with baseline OVs). CONCLUSIONS: In patients with compensated HCV-related cirrhosis with or without OVs at baseline, SVR is associated with reduced disease progression and liver-related mortality.
Authors: Loreta A Kondili; Federica Romano; Francesca Romana Rolli; Matteo Ruggeri; Stefano Rosato; Maurizia Rossana Brunetto; Anna Linda Zignego; Alessia Ciancio; Alfredo Di Leo; Giovanni Raimondo; Carlo Ferrari; Gloria Taliani; Guglielmo Borgia; Teresa Antonia Santantonio; Pierluigi Blanc; Giovanni Battista Gaeta; Antonio Gasbarrini; Luchino Chessa; Elke Maria Erne; Erica Villa; Donatella Ieluzzi; Francesco Paolo Russo; Pietro Andreone; Maria Vinci; Carmine Coppola; Liliana Chemello; Salvatore Madonia; Gabriella Verucchi; Marcello Persico; Massimo Zuin; Massimo Puoti; Alfredo Alberti; Gerardo Nardone; Marco Massari; Giuseppe Montalto; Giuseppe Foti; Maria Grazia Rumi; Maria Giovanna Quaranta; Americo Cicchetti; Antonio Craxì; Stefano Vella Journal: Hepatology Date: 2017-10-30 Impact factor: 17.425
Authors: Loreta A Kondili; Giovanni Battista Gaeta; Maurizia Rossana Brunetto; Alfredo Di Leo; Andrea Iannone; Teresa Antonia Santantonio; Adele Giammario; Giovanni Raimondo; Roberto Filomia; Carmine Coppola; Daniela Caterina Amoruso; Pierluigi Blanc; Barbara Del Pin; Liliana Chemello; Luisa Cavalletto; Filomena Morisco; Laura Donnarumma; Maria Grazia Rumi; Antonio Gasbarrini; Massimo Siciliano; Marco Massari; Romina Corsini; Barbara Coco; Salvatore Madonia; Marco Cannizzaro; Anna Linda Zignego; Monica Monti; Francesco Paolo Russo; Alberto Zanetto; Marcello Persico; Mario Masarone; Erica Villa; Veronica Bernabucci; Gloria Taliani; Elisa Biliotti; Luchino Chessa; Maria Cristina Pasetto; Pietro Andreone; Marzia Margotti; Giuseppina Brancaccio; Donatella Ieluzzi; Guglielmo Borgia; Emanuela Zappulo; Vincenza Calvaruso; Salvatore Petta; Loredana Falzano; Maria Giovanna Quaranta; Liliana Elena Weimer; Stefano Rosato; Stefano Vella; Edoardo Giovanni Giannini Journal: PLoS One Date: 2017-10-04 Impact factor: 3.240