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Impact of direct-acting antiviral agents on liver function in patients with chronic hepatitis C virus infection

Philip J Johnson1, Sarah Berhane1, Alex J Walker2

  • 1Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.

Journal of Viral Hepatitis
|September 26, 2020
PubMed

Insights

Direct-acting antiviral agents (DAAs) improve liver function, especially in patients with decompensated chronic hepatitis C (HCV) who achieve sustained virological response (SVR). Long-term outcomes suggest DAAs may lead to disease improvement similar to interferon-based therapies.

Area of Science:

  • Hepatology
  • Virology
  • Internal Medicine

Background:

  • Direct-acting antiviral agents (DAAs) are effective for treating chronic hepatitis C (HCV).
  • The impact of DAAs on liver function, particularly in relation to sustained virological response (SVR), requires further documentation.
  • Liver function assessment using the albumin-bilirubin (ALBI) score is crucial for predicting outcomes in chronic liver disease.

Purpose of the Study:

  • To evaluate the impact of DAAs on liver function in patients with chronic HCV.
  • To compare liver function changes between DAA therapy and interferon-based therapy.
  • To examine the relationship between SVR achievement and liver function improvement with DAAs.

Main Methods:

  • A study of 2394 patients with chronic HCV infection, including 1276 on DAAs and 1118 on interferon-based therapy.
  • Assessment of liver function using the albumin-bilirubin (ALBI) score and grade.
  • Analysis of overall survival, time to decompensation, and longitudinal changes in ALBI score based on SVR status and baseline ALBI grade.

Main Results:

  • 89% of patients receiving DAAs achieved SVR (99% in Japan, 78% in the UK).
  • DAAs demonstrated improvement in liver function within 2 years, especially in UK patients with decompensated disease who achieved SVR.
  • These improvements were comparable to those seen after interferon-based therapy.

Conclusions:

  • DAAs significantly improve liver function in patients with chronic HCV, particularly those with decompensated disease who achieve SVR.
  • Long-term outcomes suggest that achieving SVR with DAAs may lead to sustained liver function improvement.
  • DAA therapy is likely to result in long-term disease improvement and stabilization, mirroring outcomes observed with successful interferon-based treatment.
Keywords:
ALBI scoredirect-acting antiviralshepatitis C virusinterferon therapyliver functionsustained virological response

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