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A sustained viral response is associated with reduced liver-related morbidity and mortality in patients with

Amit G Singal1, Michael L Volk, Donald Jensen

  • 1Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, Michigan, USA.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|December 2, 2009
PubMed

Insights

Achieving sustained viral response (SVR) significantly reduces liver-related mortality, hepatocellular carcinoma (HCC), and decompensated cirrhosis in hepatitis C virus (HCV) patients. Patients failing treatment face substantial risks without SVR.

Area of Science:

  • Hepatology
  • Viral Hepatitis Research
  • Clinical Outcomes Research

Background:

  • Hepatitis C virus (HCV) infection can lead to severe liver complications.
  • The long-term outcomes for HCV patients achieving sustained viral response (SVR) versus treatment failure are not fully understood.
  • Key outcomes of concern include decompensated cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality.

Purpose of the Study:

  • To quantify the incidences of decompensated cirrhosis, HCC, and liver-related mortality in HCV patients.
  • To compare these outcomes between patients who achieve SVR and those who experience treatment failure.
  • To analyze outcomes specifically in HCV patients with advanced fibrosis.

Main Methods:

  • A meta-analysis of observational cohort studies was conducted.
  • Studies included HCV patients who failed treatment, with data stratified by SVR status.
  • Data extraction was performed by two independent investigators with over 95% agreement.

Main Results:

  • The meta-analysis included 26 studies.
  • Among HCV patients with advanced fibrosis who failed treatment, significant annual rates of liver-related mortality (2.73%), HCC (3.22%), and hepatic decompensation (2.92%) were observed.
  • Patients achieving SVR had significantly lower risks of liver-related mortality (RR 0.23), HCC (RR 0.21), and hepatic decompensation (RR 0.16) compared to treatment failure patients.

Conclusions:

  • HCV patients with advanced fibrosis who do not achieve SVR face substantial liver-related morbidity and mortality.
  • Achieving SVR dramatically lowers the risk of severe liver complications and death in HCV patients.
  • SVR is a critical determinant of improved long-term outcomes for hepatitis C patients.
Abstract

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