In patients with chronic hepatitis C virus (HCV) infection, achieving a sustained virologic response as a result of treatment with interferon-based therapy or direct-acting antivirals is associated with a reduced risk for developing hepatocellular carcinoma (HCC) and all-cause mortality, according to study results published in Scientific Reports.1
Patients with advanced hepatic fibrosis are at increased risk for HCC or hepatic decompensation within a short period of time. However, this risk can be decreased with HCV eradication by immediate initiation of antiviral therapy.2-7 Therefore, researchers sought to analyze the association between eradication of HCV and the risk for HCC occurrence and death in HCV-infected patients according to hepatic fibrosis grade.1 The fibrosis grade was categorized using the Fibrosis-4 (FIB-4) index for liver fibrosis, with scores <1.45 having a low probability of significant fibrosis, 1.45 to 3.25 an intermediate probability of significant fibrosis, and ³3.25 a high probability of significant fibrosis.
The researchers found that of 1373 patients with chronic hepatitis C, 418 were treated with interferon-based therapy and 326 with direct-acting antivirals, and 622 of these patients (83.6%) achieved a sustained virologic response. The sustained virologic response group had a significantly lower risk for HCC than patients in the untreated group with intermediate-probability (P =.004) and high-probability (P <.001) of significant fibrosis. Thus, sustained virologic response was independently associated with a lower risk for HCC (P <.001) and overall death (P <.001) compared with untreated patients.