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Liver and cardiovascular mortality after hepatitis C virus eradication by DAA: Data from RESIST-HCV cohort

Vincenza Calvaruso1, Salvatore Petta1, Irene Cacciola2,3

  • 1Gastroenterology and Hepatology Unit, Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialities, PROMISE, University of Palermo, Palermo, Italy.

Journal of Viral Hepatitis
|April 25, 2021
PubMed

Insights

Achieving sustained virologic response (SVR) with direct-acting antivirals for Hepatitis C Virus (HCV) significantly improves liver and cardiovascular survival. HCV eradication benefits patients, especially those with compensated liver disease.

Area of Science:

  • Hepatology
  • Virology
  • Public Health

Background:

  • Limited real-world data exists on Hepatitis C Virus (HCV) chronic liver disease outcomes post-Sustained Virologic Response (SVR) with direct-acting antiviral drugs (DAAs).
  • The impact of HCV eradication on patient mortality remains incompletely understood.

Purpose of the Study:

  • To evaluate the post-treatment survival of patients with HCV after achieving SVR with DAAs.
  • To assess the predictors of liver and cardiovascular mortality in this cohort.

Main Methods:

  • Analysis of the RESIST-HCV cohort (4307 patients) treated with DAAs between March 2015 and December 2016.
  • Utilized proportional cause-specific hazard regression for competing risks to evaluate survival and identify mortality predictors.
  • Follow-up median of 73 weeks, assessing liver and cardiovascular outcomes.

Main Results:

  • 94.7% of patients achieved SVR; 5.3% remained HCV RNA-positive.
  • SVR was linked to significantly decreased liver mortality (HR 0.09) and cardiovascular mortality (HR 0.07).
  • Platelet count, albumin, diabetes, and chronic kidney disease were identified as significant predictors for mortality.

Conclusions:

  • SVR achieved with DAAs is associated with improved liver and cardiovascular survival in HCV patients.
  • HCV eradication demonstrates the most significant survival benefits in patients with compensated liver disease.
  • DAA therapy offers a promising strategy for improving long-term outcomes in chronic Hepatitis C.

Keywords:
chronic hepatitiscirrhosiscompeting riskssurvival

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