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Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C
Adriaan J van der Meer1, Bart J Veldt, Jordan J Feld
1Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
JAMA
|December 27, 2012
Summary
Achieving sustained virological response (SVR) in chronic hepatitis C virus (HCV) patients with advanced liver fibrosis significantly reduces the risk of all-cause mortality. This vital outcome highlights the importance of successful HCV treatment for long-term survival.
Area of Science:
- Hepatology
- Virology
- Clinical Medicine
Background:
- Chronic hepatitis C virus (HCV) infection is a leading cause of liver failure, hepatocellular carcinoma (HCC), and liver-related death.
- Advanced hepatic fibrosis or cirrhosis significantly increases morbidity and mortality in HCV patients.
Purpose of the Study:
- To evaluate the association between sustained virological response (SVR) and all-cause mortality.
- To assess the impact of SVR on liver failure, HCC, and liver-related mortality or transplantation in HCV patients with advanced fibrosis.
Main Methods:
- International, multicenter, long-term follow-up study of 530 patients with chronic HCV and advanced hepatic fibrosis (Ishak score 4-6).
- Patients received interferon-based treatment between 1990 and 2003.
- Follow-up extended from January 2010 to October 2011, assessing all-cause mortality and secondary outcomes.
Main Results:
- SVR was achieved by 36% of patients (n=192).
- The 10-year all-cause mortality rate was significantly lower in patients with SVR (8.9%) compared to those without SVR (26.0%; P < .001).
- SVR was associated with a reduced risk of all-cause mortality (HR, 0.26) and liver-related mortality or transplantation (HR, 0.06).
Conclusions:
- Sustained virological response to interferon-based treatment in chronic HCV patients with advanced hepatic fibrosis is linked to significantly lower all-cause mortality.
- SVR also reduces the incidence of liver failure, HCC, and liver-related mortality or transplantation.
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