In the Journals

Survival among HCV patients with SVR reaches that of general population

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November 11, 2014

The life expectancy of patients with hepatitis C virus infection and advanced hepatic fibrosis or cirrhosis who achieved sustained virologic response was comparable with that of the general population, according to a research letter published in JAMA.

Adriaan J. van der Meer, MD, PhD, of Erasmus MC University Medical Center Rotterdam, Netherlands, and colleagues compared the overall survival of 530 patients with chronic HCV infection and advanced fibrosis or cirrhosis before therapy, with and without SVR, with the expected survival of the general population in the Netherlands, matched by age and sex. The HCV patients initiated interferon-based therapy between 1990 and 2003 at five large hepatology units in Europe and Canada, and were followed for a median of 8.4 years.

Follow-up, which began 24 weeks after the cessation of therapy, was completed by 454 patients (86%). The median age of the patients was 48 years, 70% were male and 192 attained SVR. Thirteen patients with SVR died. The cumulative 10-year survival rate was 91.1% (95% CI, 85.5%-96.7%), which did not differ from that of the general population (P=.57).
Conversely, 100 patients who failed to achieve SVR died, bringing the cumulative 10-year survival rate to 74% (95% CI, 71.6%-79.8%). This was lower compared with the general population (P<.001), the researchers said.

“The excellent survival among patients with advanced liver disease and SVR might be explained by the associations between SVR and regression of hepatic inflammation and fibrosis, reduced hepatic venous pressure gradient, reduced occurrence of hepatocellular carcinoma and liver failure, as well as reduced occurrence of diabetes mellitus, end-stage renal disease, and cardiovascular events,” they wrote.

Disclosure: See the study for a full list of relevant financial disclosures.

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