Link to open access journal – AF
WEDNESDAY, Jan. 4, 2017 (HealthDay News) — For patients with hepatitis C virus (HCV) infection and biopsy-proven cirrhosis, sustained viral response (SVR) is associated with a reduction in critical events, both liver and non-liver related, according to research published in the January issue of Gastroenterology.
Pierre Nahon, M.D., Ph.D., from the Hôpital Jean Verdier in Bondy, France, and colleagues conducted a retrospective review using data from 1,323 patients in a prospective viral cirrhosis cohort. Patients had HCV infection and biopsy-proven cirrhosis, were Child-Pugh class A, and had no previous liver complications. Patients received anti-HCV treatment before or after inclusion and underwent ultrasound examination every six months, as well as endoscopic assessments.
The researchers found that 50.5 percent of the patients achieved SVR after a median follow-up of 58.2 months. SVR correlated with reduced incidence of hepatocellular carcinoma and hepatic decompensation (hazard ratios, 0.29 and 0.26, respectively). The risks of cardiovascular events and bacterial infections were also lower with SVRs (hazard ratios, 0.42 and 0.44, respectively). In patients with SVRs, but not patients with viremia, metabolic features correlated with higher risk of hepatocellular carcinoma. SVR correlated with a reduction in overall mortality (hazard ratio, 0.27) and death from liver-related and non-liver-related causes.
Article: Eradication of Hepatitis C Virus Infection in Patients With Cirrhosis Reduces Risk of Liver and Non-Liver Complications—Nahon et. al
Study Aims and Results: The authors evaluate if curing hepatitis C reduces illness and death. Information was collected from 35 centers located throughout France. The data included 1,323 hepatitis C patients with compensated cirrhosis—the cirrhotic patients did not have complications from cirrhosis. Compensated cirrhosis was confirmed by liver biopsy.
Editorial Note: Compensated cirrhosis is the first stage of cirrhosis. People with compensated may experience few or no symptoms. The medical goal of people infected with chronic hepatitis C who have progressed to compensated cirrhosis is to treat it, and cure it
The patients were treated with interferon-based therapy and direct-acting antiviral therapies.
Conclusion: After a mean follow-up period of 58 months, 50.5% (668 patients) were cured. Being cured of hepatitis C was associated with decreased rate of liver cancer, and decreased progression to decompensated cirrhosis. Curing hepatitis C also lowered the risk of cardiovascular events (heart disease), and bacterial infections.
In the entire study, 175 patients or 13.5% died during the follow-up period—this means that there was an 88.6% 5-year survival. Ninety-one patients died of liver complications and 66 patients died of non-liver complications.
The study was able to confirm that being cured of chronic hepatitis C improved liver related health and importantly non-liver related health issues such as cardiovascular deaths.
Editorial Comments: This is a fairly large and encouraging study. Most people who were cured of hepatitis C had positive long-term outcomes. There is a need for more and larger studies with only direct-acting antiviral medications to fully understand the long-term benefits of curing people with hepatitis C.
Anecdotally, I hear from many people that they feel so much better physically, emotionally and spiritually after being cured that it feels like a second lease on life.