Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population

Savino Bruno, Vito Di Marco, Massimo Iavarone, Luigi Roffi, Andrea Crosignani, Vincenza Calvaruso, Alessio Aghemo, Giuseppe Cabibbo, Mauro Viganò, Vincenzo Boccaccio, Antonio Craxí, Massimo Colombo, Patrick Maisonneuve

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims: Life expectancy of patients with compensated hepatitis C virus (HCV) cirrhosis achieving sustained virologic response (SVR) is limited by liver events as compared to the general population. Thus, survival benefit of SVR remains to be measured. Methods: The study includes prospective surveillance data from three cohorts of Italian patients with compensated HCV cirrhosis who achieved SVR on an interferon-based (IFN) regimen, compared to simultaneously observed non-SVR, untreated and decompensated patients. Overall survival was calculated from the date of start of IFN to death. The number of deaths expected during the at-risk period was determined by applying age- and sex-specific mortality rates recorded in Italy for person-years adequate for the enrolment period. The standardized mortality ratio (SMR) determined the relative risk of death over that of the age and sex matched general population. Results: Overall, 28/181 patients followed-up for a median period of 9.6. years (range 1-25. years) died. The 10 and 20-year overall survival rates for the whole series were 90.9% (95% CI, 84.3-94.8) and 62.9% (95% CI, 45.9-75.9), respectively. The number of expected deaths in the corresponding age and sex matched general population was 28.1, corresponding to a SMR = 1.00 (95% CI, 0.72-1.35), with an SMR for non-SVR patients of 3.85 (95% CI, 3.43-4.30), for untreated of 3.01 (95% CI, 2.64-3.42) and for decompensated of 6.70 (95% CI, 5.39-8.22). Conclusions: Patients with compensated HCV cirrhosis achieving SVR by IFN obtain a main benefit levelling their survival curve to that of the general population. Wider applicability of IFN-free regimens will possibly make this achievement more generalizable.

Original languageEnglish
JournalJournal of Hepatology
DOIs
Publication statusAccepted/In press - Aug 25 2015

Keywords

  • Antiviral therapy
  • DAA's
  • HCV-related cirrhosis
  • IFN-based therapy
  • SVR

ASJC Scopus subject areas

  • Hepatology

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