The impact of sustained virologic response (SVR) on mortality after direct-acting antiviral treatment is not well documented. This study evaluated the impact of direct-acting antiviral-induced SVR on all-cause mortality and on incident hepatocellular carcinoma (HCC) in 15,059 hepatitis C virus-infected patients with advanced liver disease defined by a FIB-4 >3.25. Overall, 1,067 patients did not achieve SVR (no SVR) and 13,992 patients achieved SVR. In a mean follow-up period of approximately 1.6 years, 195 no SVR patients and 598 SVR patients died. Mortality rates were 12.3 deaths/100 patient years of follow-up for no SVR patients and 2.6 deaths/100 patient years for SVR patients, a 78.9% reduction (P < 0.001). Among patients without a prior diagnosis of HCC, 140 no SVR patients and 397 SVR patients were diagnosed with incident HCC. HCC rates were 11.5 HCCs/100 patient years for no SVR patients and 1.9 HCCs/100 patient years for SVR patients, an 83.5% reduction (P < 0.001). In multivariable Cox proportional hazard models controlling for baseline demographics, clinical characteristics, and comorbidities, SVR was independently associated with reduced risk of death compared to no SVR (hazard ratio, 0.26; 95% confidence interval, 0.22-0.31; P < 0.001). A history of decompensated liver disease (hazard ratio, 1.57; 95% confidence interval, 1.34-1.83; P < 0.001) and decreased albumin (hazard ratio, 2.70 per 1 g/dL decrease; 95% confidence interval, 2.38-3.12; P < 0.001) were independently associated with increased risk of death. Conclusion: Those achieving SVR after direct-acting antiviral treatment had significantly lower all-cause mortality and lower incident HCC rates than those who did not achieve SVR. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
The impact of sustained virologic response (SVR) on mortality after direct-acting antiviral treatment is not well documented. This study evaluated the impact of direct-acting antiviral-induced SVR on all-cause mortality and on incident hepatocellular carcinoma (HCC) in 15,059 hepatitis C virus-infectedpatients with advanced liver disease defined by a FIB-4 >3.25. Overall, 1,067 patients did not achieve SVR (no SVR) and 13,992 patients achieved SVR. In a mean follow-up period of approximately 1.6 years, 195 no SVR patients and 598 SVR patients died. Mortality rates were 12.3 deaths/100 patient years of follow-up for no SVR patients and 2.6 deaths/100 patient years for SVR patients, a 78.9% reduction (P < 0.001). Among patients without a prior diagnosis of HCC, 140 no SVR patients and 397 SVR patients were diagnosed with incident HCC. HCC rates were 11.5 HCCs/100 patient years for no SVR patients and 1.9 HCCs/100 patient years for SVR patients, an 83.5% reduction (P < 0.001). In multivariable Cox proportional hazard models controlling for baseline demographics, clinical characteristics, and comorbidities, SVR was independently associated with reduced risk of death compared to no SVR (hazard ratio, 0.26; 95% confidence interval, 0.22-0.31; P < 0.001). A history of decompensated liver disease (hazard ratio, 1.57; 95% confidence interval, 1.34-1.83; P < 0.001) and decreased albumin (hazard ratio, 2.70 per 1 g/dL decrease; 95% confidence interval, 2.38-3.12; P < 0.001) were independently associated with increased risk of death. Conclusion: Those achieving SVR after direct-acting antiviral treatment had significantly lower all-cause mortality and lower incident HCC rates than those who did not achieve SVR. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Authors: Kelly A Borges; Jianliang Dai; Neehar D Parikh; Myron Schwartz; Mindie H Nguyen; Lewis R Roberts; Alex S Befeler; Sudhir Srivastava; Jo Ann Rinaudo; Ziding Feng; Jorge A Marrero; K Rajender Reddy Journal: Contemp Clin Trials Date: 2018-11-12 Impact factor: 2.226
Authors: Albert Do; Denise A Esserman; Supriya Krishnan; Joseph K Lim; Tamar H Taddei; Ronald G Hauser; Janet P Tate; Vincent Lo Re; Amy C Justice Journal: J Gen Intern Med Date: 2020-04-27 Impact factor: 5.128
Authors: Nicole E Rich; Ju Dong Yang; Ponni V Perumalswami; Naim Alkhouri; Whitney Jackson; Neehar D Parikh; Neil Mehta; Reena Salgia; Andres Duarte-Rojo; Laura Kulik; Mina Rakoski; Adnan Said; Omobonike Oloruntoba; George N Ioannou; Maarouf A Hoteit; Andrew M Moon; Amol S Rangnekar; Sheila L Eswaran; Elizabeth Zheng; Janice H Jou; James Hanje; Anjana Pillai; Ruben Hernaez; Robert Wong; Steven Scaglione; Hrishikesh Samant; Devika Kapuria; Shaun Chandna; Russell Rosenblatt; Veeral Ajmera; Catherine T Frenette; Sanjaya K Satapathy; Parvez Mantry; Prasun Jalal; Binu V John; Oren K Fix; Michael Leise; Christina C Lindenmeyer; Avegail Flores; Nayan Patel; Z Gordon Jiang; Nyan Latt; Renumathy Dhanasekaran; Mobolaji Odewole; Sofia Kagan; Jorge A Marrero; Amit G Singal Journal: Clin Gastroenterol Hepatol Date: 2019-07-26 Impact factor: 11.382