Patients who have chronic hepatitis C virus and advanced hepatic fibrosis had lower all-cause mortality if they had a sustained virological response to interferon-based treatment, according to research published in the Journal of the American Medical Association.
The researchers, from Erasmus MC University Medical Center in Rotterdam, the Netherlands, conducted a long-term follow-up study of 530 patients with chronic HCV from five hospitals in Europe and Canada. The patients all started an interferon-based regimen between 1990 and 2003 and had advanced hepatic fibrosis or cirrhosis. The patients were followed for a median of 8.4 years.
Achieving SVR was associated with a reduced risk for all-cause mortality. Of the 530 patients, 192 achieved SVR, of which 13 died. Among the patients who did not achieve SVR, 100 died. The 10-year cumulative all-cause mortality rate was 8.9% for those who achieved SVR and 26% for those who did not.
SVR was also associated with reduced risk liver-related mortality or liver transplantation. Three patients who achieved an SVR underwent liver transplantation, as did 103 without SVR. The 10-year cumulative incidence rate for liver-related mortality or transplantation was 1.9% for those who achieved SVR and 27.4% for those that did not.
Among those who achieved SVR, their 10-year cumulative incidence rate of hepatocellular carcinoma was 5.1% vs. 21.8% among those who did not. For liver failure, the 10-year cumulative incidence rate was 2.1% for those who achieved SVR, vs. 29.9% for those who did not.
“The retrospective nature of our study could have led to a selection of a relatively healthy cirrhotic HCV population, because patients with most severe clinical characteristics are usually not considered for antiviral treatment,” the researchers wrote. “Because of the long follow-up duration and high number of patients with severe cirrhosis, we registered sufficient events to show a clear decrease in all-cause mortality and liver-related morbidity in patients with SVR.”
Disclosure: The researchers report financial relationships with Abbott, Anadys, AstraZeneca, Boehringer Ingelheim, Bristol Myers-Squibb, Clinical Care Options, Gilead, GlaxoSmithKline, Hoffmann-LaRoche, Janssen, Santaris, Medtronic, Merck, MSD, Novartis, Roche, Tibotec and Vertex.