Impact of virus eradication in patients with compensated hepatitis C virus-related cirrhosis: competing risks and multistate model

Salvatore Petta, Vito Di Marco, Savino Bruno, Marco Enea, Vincenza Calvaruso, Vincenzo Boccaccio, Sonia Rossi, Antonio Craxì, Calogero Cammà

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1765-1773
Number of pages9
JournalLiver International
Volume36
Issue number12
DOIs
Publication statusPublished - Dec 1 2016

Keywords

  • cirrhosis
  • HCV
  • multistate
  • SVR

ASJC Scopus subject areas

  • Hepatology

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