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Impact of virus eradication in patients with compensated hepatitis C virus‐related cirrhosis: competing risks and multistate model
Author(s) -
Petta Salvatore,
Di Marco Vito,
Bruno Savino,
Enea Marco,
Calvaruso Vincenza,
Boccaccio Vincenzo,
Rossi Sonia,
Craxì Antonio,
Cammà Calogero
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13156
Subject(s) - medicine , cirrhosis , hepatocellular carcinoma , decompensation , gastroenterology , hepatitis c virus , liver disease , cohort , portal hypertension , hepatitis c , virus , immunology
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 ( OV s) 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 OV s 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 OV s; 29.6% vs. 64.3% of patients with baseline OV s). Achievement of SVR was significantly associated with reduced occurrence rates of de‐novo OV s, 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 OV s; 50.5% vs. 21.8% of patients with baseline OV s). Conclusions In patients with compensated HCV ‐related cirrhosis with or without OV s at baseline, SVR is associated with reduced disease progression and liver‐related mortality.