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

S. Bruno, V. De Marco, M. Iavarone, Luigi Roffi, Andrea Crosignani, Vicenza Calvaruso, A. Aghemo, G Cabibbo, Mauro Viganò, Vincenzo Boccaccio, Antonio Craxí, Massimo Colombo, P. Maisonneuve

Research output: Contribution to journalArticle

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. © 2016 European Association for the Study of the Liver.
Original languageEnglish
Pages (from-to)1217-1223
Number of pages7
JournalJournal of Hepatology
Volume64
Issue number6
DOIs
Publication statusPublished - 2016

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Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population. / Bruno, S.; De Marco, V.; Iavarone, M.; Roffi, Luigi; Crosignani, Andrea; Calvaruso, Vicenza; Aghemo, A.; Cabibbo, G; Viganò, Mauro; Boccaccio, Vincenzo; Craxí, Antonio; Colombo, Massimo; Maisonneuve, P.

In: Journal of Hepatology, Vol. 64, No. 6, 2016, p. 1217-1223.

Research output: Contribution to journalArticle

Bruno, S. ; De Marco, V. ; Iavarone, M. ; Roffi, Luigi ; Crosignani, Andrea ; Calvaruso, Vicenza ; Aghemo, A. ; Cabibbo, G ; Viganò, Mauro ; Boccaccio, Vincenzo ; Craxí, Antonio ; Colombo, Massimo ; Maisonneuve, P. / Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population. In: Journal of Hepatology. 2016 ; Vol. 64, No. 6. pp. 1217-1223.
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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. {\circledC} 2016 European Association for the Study of the Liver.",
keywords = "Antiviral therapy, DAA's, HCV-related cirrhosis, IFN-based therapy, SVR",
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TY - JOUR

T1 - Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population

AU - Bruno, S.

AU - De Marco, V.

AU - Iavarone, M.

AU - Roffi, Luigi

AU - Crosignani, Andrea

AU - Calvaruso, Vicenza

AU - Aghemo, A.

AU - Cabibbo, G

AU - Viganò, Mauro

AU - Boccaccio, Vincenzo

AU - Craxí, Antonio

AU - Colombo, Massimo

AU - Maisonneuve, P.

N1 - Cited By :13 Export Date: 29 March 2017

PY - 2016

Y1 - 2016

N2 - 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. © 2016 European Association for the Study of the Liver.

AB - 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. © 2016 European Association for the Study of the Liver.

KW - Antiviral therapy

KW - DAA's

KW - HCV-related cirrhosis

KW - IFN-based therapy

KW - SVR

U2 - 10.1016/j.jhep.2016.01.034

DO - 10.1016/j.jhep.2016.01.034

M3 - Article

VL - 64

SP - 1217

EP - 1223

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

IS - 6

ER -